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Ultrasound Med Biol. 2019 Jul;45(7):1545-1550. doi: 10.1016/j.ultrasmedbio.2019.02.027. Epub 2019 Apr 26.

The Relationship Between Fluid Accumulation in Ultrasonography and the Diagnosis and Prognosis of Patients with Necrotizing Fasciitis.

Author information

1
Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
2
Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Medicine, Chang Gung University, Taoyuan, Taiwan.
3
Department of Internal Medicine, Division of Infectious Diseases, Chang Gung Memorial Hospital, Chiayi, Taiwan.
4
Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Optometry, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.
5
Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: ljnjohn@gmail.com.

Abstract

Necrotizing fasciitis is a severe soft-tissue infection with a high mortality rate. There is little literature on the relationship between the ultrasonographic finding of fluid accumulation along the deep fascia and the diagnosis and prognosis of necrotizing fasciitis. This retrospective study showed that when fluid accumulation was present along the deep fascia, patients with clinically suspected necrotizing fasciitis had a higher probability of having necrotizing fasciitis. The ultrasonographic finding of fluid accumulation with a cutoff point of more than 2 mm of depth had the best accuracy (72.7%) for diagnosing necrotizing fasciitis. In regard to the prognosis of necrotizing fasciitis, when fluid accumulation was present along the deep fascia, patients with necrotizing fasciitis had a longer length of hospital stay and were at risk of amputation or mortality. Ultrasonography is a point-of-care imaging tool that facilitates the diagnosis and prognosis of necrotizing fasciitis.

KEYWORDS:

Diagnosis; Fluid accumulation; Necrotizing fasciitis; Prognosis; Ultrasonography

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