POCUS infectious disease management: point-of-care ultrasound in the integrated management of infectious diseases

Infectious diseases are the leading cause of morbidity and death worldwide. In addition to prevention, the control of pathologies caused by biological agents depends on timely diagnosis and specific treatment. Point of care ultrasound (POCUS) has been used for over two decades for the diagnostic-therapeutic management of many critical problems, from cardiac arrest, to trauma, to circulatory and respiratory failure; at the same time, and increasingly in recent years, multiple uses have been proposed for the diagnostic approach and to support the treatment of infectious diseases. These uses are described in this review with reference to four presentation syndromes: focal manifestations from suspected localized infections; fever of unknown origin; general manifestations of suspected sepsis; pauci-asymptomatic forms in high-risk subjects. POCUS, applied in an integrated way with epidemiology, clinical evaluation and rapid laboratory investigations, allows a timely diagnostic classification in the majority of infectious pathologies, and in particular in sepsis; allows to limit the use of more complex diagnostic imaging and the use of ionizing radiation; improves the appropriateness of antibiotic therapy by limiting its prescription; guides the choice of antimicrobial therapy, thanks to the identification of the infectious source; supports non-surgical invasive eradication procedures; guides the targeted pathophysiological treatment in sepsis and septic shock.