Point-of-Care Ultrasound Assessment of Tropical Infectious Diseases—A Review of Applications and Perspectives

Abstract

Abstract. The development of good quality and affordable ultrasound machines has led to the establishment and implementation of numerous point-of-care ultrasound (POCUS) protocols in various medical disciplines. POCUS for major infectious diseases endemic in tropical regions has received less attention, despite its likely even more pronounced benefit for populations with limited access to imaging infrastructure. Focused assessment with sonography for HIV-associated TB (FASH) and echinococcosis (FASE) are the only two POCUS protocols for tropical infectious diseases, which have been formally investigated and which have been implemented in routine patient care today. This review collates the available evidence for FASH and FASE, and discusses sonographic experiences reported for urinary and intestinal schistosomiasis, lymphatic filariasis, viral hemorrhagic fevers, amebic liver abscess, and visceral leishmaniasis. Potential POCUS protocols are suggested and technical as well as training aspects in the context of resourcelimited settings are reviewed. Using the focused approach for tropical infectious diseases will make ultrasound diagnosis available to patients who would otherwise have very limited or no access to medical imaging.

Case Report: Cysticercosis: Sonographic Diagnosis of a Treatable Cause of Epilepsy and Skin Nodules

“…Certainly, it poses a diagnostic option for patients with palpable nodules as seen in our case. Cysticercosis should therefore be considered as a potential application for point-of-care ultrasound for infectious diseases, which in recent years became more frequently described 7 and more widely used in regions where other image modalities are limited.…”

Evaluation of a point of care ultrasound curriculum for Indonesian physicians taught by first-year medical students

“…[12,13,28] Some studies recommend the use of ultrasound as a supplementary diagnostic tool in the diagnosis of TB in HIV infected patients, particularly in regions with a high prevalence of TB and HIV coinfections. [29] In limited resource areas, POCUS could allow providers to make diagnoses in patients using the FASH exam. [8,30] The teaching material of this course was modeled off the guidelines and recommendations outlined by Dr. Tom Heller.…”

Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS)—pilot evaluation of a simple point-of-care ultrasound protocol and short training program for detecting urinary tract morbidity in highly endemic settings

“…Final evaluation includes multiple measurements for the calculation of a final severity score. 12 Based on the nomenclature of previous POCUS techniques 13 we named our protocol: 'Focused Assessment with Sonography for Urinary Schistosomiasis' (FASUS). The emphasis in our scan protocol was on views that are easily achievable and abnormalities that are easily recognisable for operators with no, or very little, previous ultrasound experience; for example, bladder wall thickening and renal pelvis dilation.…”

“…HIV-associated TB and echinococcosis. 13 The aim of this study was to pilot a POCUS protocol for detection of UGS-related urinary tract morbidity in symptomatic patients, to evaluate practical feasibility and evaluate the performance of operators with limited training, using low-cost equipment.…”