Role of Point-of-Care Ultrasound in the Early Diagnosis of Necrotizing Soft Tissue Infections: A Case Series

Necrotizing soft tissue infections (NSTIs), particularly necrotizing fasciitis (NF), are life-threatening conditions with high mortality, where early diagnosis is essential to improve outcomes. However, the clinical presentation often mimics less severe infections, contributing to diagnostic delays. This case series explores the utility of point-of-care ultrasound (POCUS) in the early recognition of NF through the presentation of 3 adult patients evaluated in the Emergency Department of a tertiary care center. All patients underwent bedside ultrasound at the time of admission, with findings corroborated by computed tomography (CT) imaging and surgical exploration. Key sonographic features included subcutaneous gas, fascial thickening, and fluid tracking along fascial planes-hallmarks suggestive of NSTI. These findings were consistent with CT scans and intraoperative assessments. Two patients underwent early surgical debridement with favorable clinical outcomes, while one was managed with palliative care due to poor baseline status. This series highlights the value of POCUS as an immediate, noninvasive, and valuable diagnostic tool that complements clinical and laboratory evaluation, facilitates prompt surgical intervention, and may contribute to improved survival in patients with NSTI.