Point‑of‑care ultrasonography in diagnosing necrotizing fasciitis— a literature review

• Main Authors: Gan, Rick Kye, Martinez, Antoni Sanchez, Abu Hasan, Muhammad Abdus-Syakur, Delgado, Rafael Castro, González, Pedro Arcos
• Format: Article
• Language: English; English
• Published: Springer 2023
• Subjects: RC582 Specialities of Internal Medicine- Immunologic Diseases
• Online Access: http://irep.iium.edu.my/116942/1/116942_Point%E2%80%91of%E2%80%91care%20ultrasonography%20in%20diagnosing%20necrotizing.pdf; http://irep.iium.edu.my/116942/2/116942_Point%E2%80%91of%E2%80%91care%20ultrasonography%20in%20diagnosing%20necrotizing_Scopus.pdf; http://irep.iium.edu.my/116942/; https://link.springer.com/article/10.1007/s40477-022-00761-5; https://doi.org/10.1007/s40477-022-00761-5

Introduction Necrotizing fasciitis (NF) is a rapidly progressive necrosis of the fascial layer with a high mortality rate. It is a life threatening medical emergency that requires urgent treatment. Lack of skin finding in NF made diagnosis difficult and required a high clinical index of suspicion. The use of ultrasound may guide clinicians in improving diagnostic speed and accuracy, thus leading to improved management decisions and patient outcomes. This literature search aims to review the use of point-of-care ultrasonography in diagnosing necrotizing fasciitis. Method We searched relevant electronic databases, including PUBMED, MEDLINE, and SCOPUS, and performed a systematic review. Keywords used were “necrotizing fasciitis” or “necrotising fasciitis” or “necrotizing soft tissue infections” and “point-of-care ultrasonography” “ultrasonography” or “ultrasound”. No temporal limitation was set. An additional search was performed via google scholar, and the top 100 entry was screened. Results Among 540 papers screened, only 21 were related to diagnosing necrotizing fasciitis using ultrasonography. The outcome includes three observational studies, 16 case reports, and two case series, covering the period from 1976 to 2022. Conclusion Although the use of ultrasonography in diagnosing NF was published in several papers with promising results, more studies are required to investigate its diagnostic accuracy and potential to reduce time delay before surgical intervention, morbidity, and mortality.