The role of point-of-care ultrasound in the diagnosis and management of necrotizing soft tissue infections

BACKGROUND: Necrotizing soft tissue infections are associated with high morbidity and mortality, even when the correct treatment is initiated. The diagnosis of these conditions is hard and the most sensitive methods are time-consuming, expensive and not readily available. Point-of-care ultrasound can complement clinical evaluation to increase the diagnostic accuracy. CASE PRESENTATION: We bring a case of a woman, without comorbidities, who presented to the emergency department with signs of soft tissue infection. Bedside ultrasound showed subcutaneous tissue thickening, with fluid accumulation, and subcutaneous gas in the affected area. Based on the clinical suspicion and the ultrasound findings, the patient underwent prompt medical treatment and surgical debridement. CONCLUSIONS: This case shows the utility of bedside ultrasound for the decision-making process in a disease where an early diagnosis is important. This information should always be used together with the clinical judgement, as it has a relative low sensitivity.