• Shadi Lahham, Inna Shniter, Monica Desai, Rana Andary, Soheil Saadat, John C Fox, and Scott Pierce.
• University of California Irvine, Department of Emergency Medicine, United States. Electronic address: slahham@uci.edu.
• Am J Emerg Med. 2022 Jan 1; 51: 397-400.

BackgroundNecrotizing fasciitis (NF) is a severe, life-threatening soft tissue infection requiring prompt diagnosis and immediate surgical debridement. Imaging, including a computed tomography (CT) scan, can often aid in the diagnosis, though it can prolong time to treatment and diagnosis. Point-of-care ultrasound (POCUS) is often used in the ED to identify soft tissue infections. The objective of this study is to evaluate the use of POCUS to identify NF in patients presenting to the emergency department.MethodsWe prospectively enrolled patients who presented to the emergency department (ED) with suspected soft tissue infection who received a computed tomography and/or surgical consult. POCUS images of the suspected site of infection were obtained by the emergency medicine physician and interpreted based on sonographic findings of NF. These findings were compared with CT scan or surgical impression.ResultsWe enrolled 64 patients in this study. Eight were determined to be at high risk of having NF based on CT scan and/or surgical impression. All of these patients also had POCUS images interpreted as concerning for NF. Furthermore, 56 patients were classified as being low risk for having NF based on CT scan and/or surgical impression. All but one of these patients had POCUS images interpreted as not concerning for NF.ConclusionsOur data indicates that POCUS can be used to identify NF with a high sensitivity and specificity.Copyright © 2021 Elsevier Inc. All rights reserved.

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