Ultrasonography for early detection of non‐infectious necrotizing fasciitis secondary to cutaneous loxoscelism

Martínez‐Doménech, Álvaro; García-Legaz-Martínez, Marta; Valenzuela‐Oñate, Cristian; Pérez‐Pastor, Gemma; Alfageme, Fernando; Sánchez‐Carazo, J.L.; Pérez‐Ferriols, A.

doi:10.1111/jdv.15503

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…Antibiotics, Extensive debridement N/A Transferred to another facility Alonso 2017 [ 21 ] 60 N/A N/A Left thigh Subcutaneous thickening Air, Fascial fluid I.V. Antibiotics, Intensive care, and high dose of vasopressor Patients succumb to illness 24 h later – Martínez-Doménech 2019 [ 22 ] 50 N/a N/A Right forearm Subcutaneous thickening, Fascial fluid Doppler shows reduced vascularization I.V. Antibiotics, Decompressive fasciotomy, and tissue debridement Recovered Caused by Loxosceles Rufescens spider bite Magalhaes 2020 [ 23 ] 54 Nil Linear probe Left gluteal region Subcutaneous thickening Air Fascial fluid I.V.…”

Section: Resultsmentioning

confidence: 99%

“…POCUS has also been reported to diagnose non-infective necrotizing fasciitis. Martínez-Doménech et al [ 22 ] described the use of POCUS in NF caused by the envenomation of the Loxosceles rufescens spider, which has necrotoxin property [ 31 ]. Suggest the possibility of using POCUS in monitoring the progress of envenomation and diagnosis of non-infective NF.…”

Section: Discussionmentioning

confidence: 99%

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Point-of-care ultrasonography in diagnosing necrotizing fasciitis—a literature review

et al. 2023

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Introduction Necrotizing fasciitis (NF) is a rapidly progressive necrosis of the fascial layer with a high mortality rate. It is a life-threatening medical emergency that requires urgent treatment. Lack of skin finding in NF made diagnosis difficult and required a high clinical index of suspicion. The use of ultrasound may guide clinicians in improving diagnostic speed and accuracy, thus leading to improved management decisions and patient outcomes. This literature search aims to review the use of point-of-care ultrasonography in diagnosing necrotizing fasciitis. Method We searched relevant electronic databases, including PUBMED, MEDLINE, and SCOPUS, and performed a systematic review. Keywords used were “necrotizing fasciitis” or “necrotising fasciitis” or “necrotizing soft tissue infections” and “point-of-care ultrasonography” “ultrasonography” or “ultrasound”. No temporal limitation was set. An additional search was performed via google scholar, and the top 100 entry was screened. Results Among 540 papers screened, only 21 were related to diagnosing necrotizing fasciitis using ultrasonography. The outcome includes three observational studies, 16 case reports, and two case series, covering the period from 1976 to 2022. Conclusion Although the use of ultrasonography in diagnosing NF was published in several papers with promising results, more studies are required to investigate its diagnostic accuracy and potential to reduce time delay before surgical intervention, morbidity, and mortality.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasonography in diagnosing necrotizing fasciitis—a literature review

et al. 2023

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“…Based on this case, it stands to reason that the best way to prevent other similar cases would be to ensure better patient education on recognizing loxoscelism and associated complications to facilitate earlier intervention. Additionally, the literature suggests the use of sonography for the early detection of severe infection, notably necrotizing fasciitis, secondary to cutaneous loxoscelism [ 12 ]. However, again, this intervention would have required the patient to present earlier for any advantage.…”

Section: Discussionmentioning

confidence: 99%

Spider Bite-Induced Facial Nerve Palsy

Stolzenberg¹,

Koch²,

Huang³

et al. 2022

Cureus

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Spider bites, while rarely confirmed beyond a doubt, should always be in the differential for any severe symptoms or infection out of proportion to presentation with the suspected presence of appropriate vectors. While most arthropod bites will only result in mild localized irritation, the potential to cause severe cutaneous and systemic effects should not be overlooked. We present one such case, in which a presumed brown recluse (Loxosceles reclusa) bite on the neck resulted in severe illness with systemic manifestations. The patient presented to the emergency room minimally responsive with left-sided facial nerve palsy and septic shock. While the admitting physician initially prioritized stabilizing the patient, he noted the leftsided cervical cellulitis. Thorough history taking revealed that the patient had been worsening since being bitten by a spider three days prior to admission. After a month-long hospital stay and multidisciplinary treatment, the patient was transferred to a larger center with facial paralysis still present.

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Ultrasonography for early detection of non‐infectious necrotizing fasciitis secondary to cutaneous loxoscelism

Cited by 2 publications

References 8 publications

Point-of-care ultrasonography in diagnosing necrotizing fasciitis—a literature review

Point-of-care ultrasonography in diagnosing necrotizing fasciitis—a literature review

Spider Bite-Induced Facial Nerve Palsy

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