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Case Reports
. 2023 Mar;26(1):147-150.
doi: 10.1007/s40477-022-00717-9. Epub 2023 Jan 6.

A necrotising fasciitis: case report

S Cantarella  1 , A Casamassima  2 , Dott M Bussone  2 , E Baldini  2 , A Kersik  3 , O Boccia  3 , C Gianotti  3
Affiliations
Case Reports

A necrotising fasciitis: case report

S Cantarella et al. J Ultrasound. 2023 Mar.

Abstract

Necrotizing fasciitis is one of the most common soft tissue infections, with a high risk of major amputation and a mortality ranging from 6 to 33% which has not changed in the past 20 years. Early surgical resection of necrotic tissue plays a key role in determining the prognosis. Nawijn et al. identified an optimal 6 hours window from presentation to surgery. Symptoms of necrotizing fasciitis mimic those of common skin infections, such as erysipelas and cellulitis, making rapid surgical management difficult. In this context, the aid of point-of-care-ultrasound is a valuable tool for early diagnosis, detecting the presence of subcutaneous thickening, gas and perifascial liquid. Other characteristic ultrasound findings include the "cobblestone" appearance of the subcutaneous soft tissues and reverberation artifacts due to hyperechoic outbreaks, defined as "snow globes" due to the presence of heterogeneous swirling material, and "dirty shadowing" due to the foggy shadow created by the gas.

Keywords: Early diagnosis; Fasciitis; Infection; Ultrasound; Urgency.

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Conflict of interest statement

The authors have not disclosed any competing interests.

Figures

Fig. 1
Fig. 1
Gas artifact
Fig. 2
Fig. 2
Cobblestoning
Fig. 3
Fig. 3
Thickening of the fascia
See this image and copyright information in PMC

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