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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Fluids / diagnostic imaging*
  • Edema / diagnostic imaging*
  • Edema / physiopathology*
  • Fasciitis, Necrotizing / diagnostic imaging*
  • Fasciitis, Necrotizing / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Ultrasonography / methods*
  • Young Adult