POCUS may identify Necrotizing fasciitis with high sensitivity and specificity

USA: A prospective study by Dr Shadi Lahham MD, MS, and team revealed that point-of-care ultrasound (POCUS) can be used as a diagnostic tool for the identification of necrotizing fasciitis (NF) with high sensitivity and specificity. The findings of the study are published in The American Journal of Emergency Medicine.

Necrotizing fasciitis (NF), also known as flesh-eating disease, is a bacterial infection that results in the death of parts of the body's soft tissue. The incidence of necrotizing fasciitis in adults is 0.40 cases per 100,000 people/year and the incidence in children is higher at 0.08 cases per 100,000 people/year. It requires prompt diagnosis and immediate surgical debridement.

Dr. Lahham and colleagues aimed to evaluate the use of POCUS to identify NF in patients presenting to the emergency department.

The study enrolled patients who presented to the emergency department (ED) with suspected soft tissue infection who received a computed tomography 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.

The results of the study were:

• A total of 64 patients were enrolled prospectively in the 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.

• 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.

Lahham and the team concluded that "Our data indicate that POCUS can be used to identify NF with a high sensitivity and specificity."

Reference: https://doi.org/10.1016/j.ajem.2021.10.033