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Title: What's the Diagnosis?

Category: Visual Diagnosis

Posted: 1/27/2014 by Haney Mallemat, MD

Question

32 year-old with diabetes presents with fever, erythema, and warmth of his lower extremity; his leg is not particularly painful. He is diagnosed with cellulitis, started on antibiotics, and admitted to the hospital. While boarding in the Emergency Department he becomes rigorous and hypotensive. An ultrasound of his cellulitis is performed and is shown below. What’s the diagnosis?

 

Answer

"Cobblestoning" of subcutaneous tissue consistent with cellulitis. There are also areas of subcutaneous air raising the concern for necrotizing fasciitis.

Special thanks to Dr. Mike Mallin from the Ultrasound Podcast for the clip. Want to see more amazing ultrasound clips? Check out Sonocloud

References

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