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Revista Cubana de Medicina Intensiva y Emergencias

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2020, Number 1

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Rev Cub Med Int Emerg 2020; 19 (1)

Usefulness of ultrasound in decision making on cellulite or soft tissue abscess

Valle AJ, Fonseca PFJ, Noblia L
Full text How to cite this article

Language: Spanish
References: 7
Page: 1-6
PDF size: 248.14 Kb.


Key words:

ultrasound, cellulitis, abscess, triceps, intensive care unit, soft tissue infection.

ABSTRACT

Traditionally, emergency physicians rely on the clinical examination to differentiate cellulite from abscess, in relation to assessing skin and soft tissue infections. The management of an abscess requires incision and drainage; while an antibiotic treatment is usually required for cellulite. Misdiagnosis often leads to unnecessary invasive procedures, sedation (for incision and drainage in pediatric patients), or a new emergency visit due to failed antibiotic therapy. We report the case of a 35-year-old patient, who went to the health center for initial suspicion of cellulite. A POCUS ultrasound (point-of-care-ultrasound) was performed with the presence of an abscess of the triceps muscle. Incision and drainage were performed. The patient evolved satisfactorily.


REFERENCES

  1. Taira BR, Singer AJ, Thode HCJr, Lee CC. National epidemiology of cutaneous abscesses: 1996 to 2005. Am J Emerg Med. 2009 Mar;27(3):289-92.

  2. Hersh AL, Chambers HF, Maselli JH, Gonzales R. National trends in ambulatory visits and antibiotic prescribing for skin and soft-tissue infections. Arch Intern Med. 2008 Jul 28;168(14):1585-91.

  3. Barbic D, Chenkin J, Cho DD, Jelic T, Scheuermeyer FX. In patients presenting to the emergency department with skin and soft tissue infections what is the diagnostic accuracy of point-of-care ultrasonography for the diagnosis of abscess compared to the current standard of care? A systematic review and meta-analysis. BMJ Open. 2017;7(1):e013688.

  4. Subramaniam S, Bober J, Chao J, Zehtabchi S. Point‐of‐care ultrasound for diagnosis of abscess in skin and soft tissue infections. Academic Emergency Medicine. 2016 Nov;23(11):1298-306.

  5. Lin MJ, Neuman M, Rempell R, Monuteaux M, Levy J. Point-of-care ultrasound is associated with decreased length of stay in children presenting to the emergency department with soft tissue infection. The journal of emergency medicine. 2018 Jan 1;54(1):96-101.

  6. Whitson MR, Mayo PH. Ultrasonography in the emergency department. Critical Care. 2016 Dec;20(1):227.

  7. Alsaawi A, Alrajhi K, Alshehri A, Ababtain A, Alsolamy S. Ultrasonography for the diagnosis of patients with clinically suspected skin and soft tissue infections: a systemic review of the literature. Eur J Emerg Med. 2017;24(3):162-9. Doi: 10.1097/MEJ.0000000000000340




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Rev Cub Med Int Emerg. 2020;19