PoCUS for the management of Fournier's gangrene in the emergency department: A case report

Serious soft tissue infections in the spectrum of rapidly progressive necrosis of the fascia and subcutaneous tissue represent a clinical challenge in emergency department clinical practice. Fournier's gangrene (FG) is a presentation thereof that compromises the urogenital area. A low threshold...

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Bibliographic Details
Published in:Biomedical reports 2023-10, Vol.19 (4), p.1, Article 67
Main Authors: Vargas‑Roa, Julian, Quintero‑Vanegas, Santiago, Zuluaga‑Gómez, Mateo, Gómez‑Ortiz, Daniel, González‑Arroyave, Daniel, Ardila, Carlos
Format: Article
Language:English
Subjects:
Abdomen
Abscesses
Case Report
Case reports
Debridement
Diabetes
Diagnosis
Diagnostic systems
Edema
Emergency medical care
Emergency medical services
Emergency service
Erythema
Fascia
Fournier's gangrene
Gangrene
Health aspects
Hemodynamics
Hospitals
Imipenem
Infection
Infections
Intensive care
Magnetic resonance imaging
Mortality
Muscles
Necrosis
Obesity
Patients
Point of care testing
Sepsis
Septic shock
Skin
Soft tissues
Tomography
Type 2 diabetes
Ultrasonic imaging
Ultrasound imaging
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Summary:Serious soft tissue infections in the spectrum of rapidly progressive necrosis of the fascia and subcutaneous tissue represent a clinical challenge in emergency department clinical practice. Fournier's gangrene (FG) is a presentation thereof that compromises the urogenital area. A low threshold of clinical suspicion complementary to laboratory evaluation and imaging is necessary to act rapidly and perform diagnostic and therapeutic surgical intervention for this condition. The present study reported the case of a 63-year-old woman who was admitted with buttock skin changes for 72 h. The diagnostic impression was septic shock due to FG. Point-of-care ultrasound (PoCUS) was performed, indicating free fluid in the muscle planes, discontinuity of the muscle fascia and the presence of gas in the subcutaneous cellular tissue. The patient was taken to surgery 2 h after admission. PoCUS was indicated to have an acceptable diagnostic performance that may optimize the care of this type of patient depending on the conditions of the emergency department and the availability of other resources.
ISSN:2049-9434
2049-9442
DOI:10.3892/br.2023.1649