Lewis Dywanda L, Butts Christine J, Moreno-Walton Lisa
Section of Emergency Medicine, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
Case Rep Emerg Med. 2014;2014:935283. doi: 10.1155/2014/935283. Epub 2014 Jan 16.
Physical exam alone is often insufficient to determine whether or not cellulitis is accompanied by an abscess. Bedside ultrasound can be a valuable tool in ruling out suspected abscess by allowing direct visualization of a fluid collection. The proximity of the infection to adjacent structures can also be determined, thus aiding clinical decision making. Patients with cellulitis near the eye and nose are of particular concern due to the adjacent facial structures and the anatomy of the venous drainage. Accurately determining the presence or absence of an associated abscess in these patients is a crucial step in treatment planning. The purpose of this report is to (1) emphasize the benefits of bedside ultrasound when used in conjunction with the physical exam to rule out abscess; (2) demonstrate the utility of bedside ultrasound in planning a treatment strategy for soft tissue infection; (3) depict an instance where ultrasound detected an abscess when computed tomography (CT) scan did not.
仅靠体格检查往往不足以确定蜂窝织炎是否伴有脓肿。床边超声通过直接观察液体聚集情况，在排除疑似脓肿方面可能是一种有价值的工具。还可以确定感染与相邻结构的接近程度，从而有助于临床决策。由于相邻的面部结构和静脉引流的解剖结构，眼鼻附近患有蜂窝织炎的患者尤其值得关注。准确确定这些患者中是否存在相关脓肿是治疗计划中的关键步骤。本报告的目的是：（1）强调床边超声与体格检查结合使用以排除脓肿时的益处；（2）展示床边超声在软组织感染治疗策略规划中的实用性；（3）描述一个超声检测到脓肿而计算机断层扫描（CT）未检测到的实例。
