Point-of-Care Ultrasound Diagnosis of Fournier’s Gangrene in the Emergency Department
ePoster
Authors: Alexander Belaia, NewYork-Presbyterian Brooklyn Methodist Nessy Dahan, NewYork-Presbyterian Brooklyn Methodist Hospital Yonathan Estrella, Robert Wood Johnson Barnabas Health Community Medical Center Samuel Ayala, New York-Presbyterian Brooklyn Methodist Hospital
A major attack on the scrotal sac! The case report that you are about to read features a practical and interesting use of point-of-care ultrasound (POCUS) to help facilitate care in a critically ill patient plagued with the ominous and dangerous Fournier’s gangrene. This case report shows an intriguing example of how a non-diabetic patient developed Fournier’s gangrene. It also teaches about the LRINEC score. More importantly, the reason for submitting this to UltraCon 2024 is to provide education about the sonographic features of Fournier’s gangrene that helped expedite this patient’s care. These ultrasound findings include “dirty” shadowing and visualization of subcutaneous emphysema on POCUS. As ultrasound becomes increasingly available in emergency departments both nationally and worldwide, it is a good tool for emergency physicians to master. On a particularly busy day, when the CT scanner is down or backed up, it may be the only tool available to expedite care for a patient with the emergent condition of necrotizing fasciitis. Therefore, it is important to get comfortable with ultrasound and perform POCUS for patients with concerning history and physical exam findings (i.e. necrotic-appearing wounds and crepitus). Air is usually a later finding, but when present, is ominous.