Application of Ultrasonography in the Diagnosis of Infectious Diseases in Resource-Limited Settings

  • Enrico BrunettiEmail author
  • Tom Heller
  • Joachim Richter
  • Daniel Kaminstein
  • Daniel Youkee
  • Maria Teresa Giordani
  • Samuel Goblirsch
  • Francesca Tamarozzi
Tropical, Travel and Emerging Infections (L Chen, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Tropical, Travel and Emerging Infections


Ultrasound (US) has vast potential in the field of infectious diseases, especially so in resource-limited settings. Recent technological advances have increased availability and access to ultrasound in low-resource settings, where the burden of infectious diseases is greatest. This paper collates the evidence for the utilization of ultrasound and evaluates its effectiveness in the diagnosis and management of a range of infectious diseases. This paper explores the role of ultrasound in population-based screening for specific diseases as well as highlights its benefits for individual patient management. We describe the common diagnostic signs seen on US for common and neglected parasitic, bacterial, and viral diseases. We proceed to document the emerging field of chest US which is proving to be a superior imaging modality for the diagnosis of specific pulmonary conditions. We conclude by discussing the efforts needed to formalize and rigorously evaluate the role of ultrasound in infectious diseases.


Ultrasound Infectious disease screening Imaging for disease detection Disease detection in resource-limited settings 


Compliance with Ethical Standards

Conflict of Interest

All the authors declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Richter J, Hatz C, Haussinger D. Ultrasound in tropical and parasitic diseases. Lancet. 2003;362(9387):900–2.PubMedCrossRefGoogle Scholar
  2. 2.
    Brunetti E. Ultrasound in tropical medicine. In: Farrar J, Hotez PJ, Junghanss T, Kang G, Lalloo D, White NJ, editors. Manson’s tropical diseases. Saunders: Elsevier; 2014. p. 60–7.CrossRefGoogle Scholar
  3. 3.
    Groen RS, Leow JJ, Sadasivam V, Kushner AL. Review: indications for ultrasound use in low- and middle-income countries. Trop Med Int Health. 2011;16(12):1525–35.PubMedCrossRefGoogle Scholar
  4. 4.
    Maru DS, Schwarz R, Jason A, Basu S, Sharma A, Moore C. Turning a blind eye: the mobilization of radiology services in resource-poor regions. Glob Health. 2010;6:18.CrossRefGoogle Scholar
  5. 5.
    Training in diagnostic ultrasound: essentials, principles and standards. Report of a WHO Study Group. World Health Organ Tech Rep Ser 1998, 875 (46).Google Scholar
  6. 6.
    Elzi L, Laifer G, Sendi P, Ledermann HP, Fluckiger U, Bassetti S. Low sensitivity of ultrasonography for the early diagnosis of amebic liver abscess. Am J Med. 2004;117(7):519–22.PubMedCrossRefGoogle Scholar
  7. 7.
    Chavez-Tapia NC, Hernandez-Calleros J, Tellez-Avila FI, Torre A, Uribe M. Image-guided percutaneous procedure plus metronidazole versus metronidazole alone for uncomplicated amoebic liver abscess. Cochrane Database Syst Rev. 2009;21(1):CD004886.Google Scholar
  8. 8.
    Bammigatti C, Ramasubramanian NS, Kadhiravan T, Das AK. Percutaneous needle aspiration in uncomplicated amebic liver abscess: a randomized trial. Trop Dr. 2013;43(1):19–22.CrossRefGoogle Scholar
  9. 9.
    Jha AK, Das G, Maitra S, Sengupta TK, Sen S. Management of large amoebic liver abscess—a comparative study of needle aspiration and catheter drainage. J Indian Med Assoc. 2012;110(1):13–5.PubMedGoogle Scholar
  10. 10.
    Gupta SS, Singh O, Sabharwal G, Hastir A. Catheter drainage versus needle aspiration in management of large (>10 cm diameter) amoebic liver abscesses. ANZ J Surg. 2011;81(7–8):547–51.PubMedCrossRefGoogle Scholar
  11. 11.
    Blessmann J, Le Van A, Tannich E. Hepatic ultrasound in a population with high incidence of invasive amoebiasis: evidence for subclinical, self-limited amoebic liver abscesses. Trop Med Int Health. 2003;8(3):231–3.PubMedCrossRefGoogle Scholar
  12. 12.
    Rabello AL, Da Silva RA, Rocha RS, Katz N. Abdominal ultrasonography in acute clinical schistosomiasis mansoni. Am J Trop Med Hyg. 1994;50(6):748–52.PubMedGoogle Scholar
  13. 13.
    Richter J, Hatz C, Campagne G, Bergquist N, Jenkins J. Ultrasound in schistosomiasis—a practical guide to the standardized use of ultrasonography for the assessment of schistosomiasis-related morbidity. Geneva: World Health Organization; 2000.Google Scholar
  14. 14.
    Richter J, Domingues AL, Barata CH, Prata AR, Lambertucci JR. Report of the second satellite symposium on ultrasound in schistosomiasis. Mem Inst Oswaldo Cruz. 2001;96(Suppl):151–6.PubMedCrossRefGoogle Scholar
  15. 15.
    el Scheich T, Holtfreter MC, Ekamp H, Singh DD, Mota R, Hatz C, et al. The WHO ultrasonography protocol for assessing hepatic morbidity due to Schistosoma mansoni. Acceptance and evolution over 12 years. Parasitol Res. 2014;113(11):3915–25.PubMedCrossRefGoogle Scholar
  16. 16.
    Richter J, Correia Dacal AR, Vergetti Siqueira JG, Poggensee G, Mannsmann U, Deelder A, et al. Sonographic prediction of variceal bleeding in patients with liver fibrosis due to Schistosoma mansoni. Trop Med Int Health. 1998;3(9):728–35.PubMedCrossRefGoogle Scholar
  17. 17.
    Botelho MC, Figueiredo J, Alves H. Bladder cancer and urinary schistosomiasis in Angola. J Nephrol Res. 2015;1(1):22–4.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Hatz CF. The use of ultrasound in schistosomiasis. Adv Parasitol. 2001;48:225–84.PubMedCrossRefGoogle Scholar
  19. 19.
    Heurtier Y, Lamothe F, Develoux M, Docquier J, Mouchet F, Sellin E, et al. Urinary tract lesions due to Schistosoma haematobium infection assessed by ultrasonography in a community based study in Niger. Am J Trop Med Hyg. 1986;35(6):1163–72.PubMedGoogle Scholar
  20. 20.
    Doehring E, Ehrich JH, Bremer HJ. Reversibility of urinary tract abnormalities due to Schistosoma haematobium infection. Kidney Int. 1986;30(4):582–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Devidas A, Lamothe F, Develoux M, Mouchet F, Sellin B. Ultrasonographic assessment of the regression of bladder and renal lesions due to Schistosoma heamatobium after treatment with praziquantel. Ann Soc Delg Med Trop. 1989;69:57–65.Google Scholar
  22. 22.
    Hatz C, Mayombana C, de Savigny D, MacPherson CN, Koella JC, Degremont A, et al. Ultrasound scanning for detecting morbidity due to Schistosoma haematobium and its resolution following treatment with different doses of praziquantel. Trans R Soc Trop Med Hyg. 1990;84(1):84–8.PubMedCrossRefGoogle Scholar
  23. 23.
    Richter J. Evolution of schistosomiasis-induced pathology after therapy and interruption of exposure to schistosomes: a review of ultrasonographic studies. Acta Trop. 2000;77(1):111–31.PubMedCrossRefGoogle Scholar
  24. 24.
    Richter J, Stegemann U, Haussinger D. Hydrocele in a young boy with Schistosoma mansoni infection. Br J Urol. 2002;89:1–2.Google Scholar
  25. 25.
    Ramarakoto CE, Leutscher PD, van Dam G, Christensen NO. Ultrasonographical findings in the urogenital organs in women and men infected with Schistosoma haematobium in northern Madagascar. Trans R Soc Trop Med Hyg. 2008;102(8):767–73.PubMedCrossRefGoogle Scholar
  26. 26.
    Schleenvoigt BT, Gajda M, Baier M, Groten T, Oppel-Heuchel H, Grimm MO, et al. Placental Schistosoma haematobium infection in a German returnee from Malawi. Infection. 2014;42(6):1061–4.PubMedCrossRefGoogle Scholar
  27. 27.
    Hatz CF, Vennervald BJ, Nkulila T, Vounatsou P, Kombe Y, Mayombana C, et al. Evolution of Schistosoma haematobium-related pathology over 24 months after treatment with praziquantel among school children in southeastern Tanzania. Am J Trop Med Hyg. 1998;59(5):775–81.PubMedGoogle Scholar
  28. 28.
    Wagatsuma Y, Aryeetey ME, Sack DA, Morrow RH, Hatz C, Kojima S. Resolution and resurgence of Schistosoma haematobium-induced pathology after community-based chemotherapy in Ghana, as detected by ultrasound. J Infect Dis. 1999;179(6):1515–22.PubMedCrossRefGoogle Scholar
  29. 29.
    Homeida M, Ahmed S, Dafalla A, Suliman S, Eltom I, Nash T, et al. Morbidity associated with Schistosoma mansoni infection as determined by ultrasound: a study in Gezira, Sudan. Am J Trop Med Hyg. 1988;39(2):196–201.PubMedGoogle Scholar
  30. 30.
    Magak P, Chang-Cojulun A, Kadzo H, Ireri E, Muchiri E, Kitron U, et al. Case–control study of posttreatment regression of urinary tract morbidity among adults in Schistosoma haematobium-endemic communities in Kwale County, Kenya. Am J Trop Med Hyg. 2015;93(2):371–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Akpata R, Neumayr A, Holtfreter MC, Krantz I, Singh DD, Mota R, et al. Erratum to: the WHO ultrasonography protocol for assessing morbidity due to Schistosoma haematobium. Acceptance and evolution over 14 years. Systematic review. Parasitol Res. 2015;114(5):2045–6.PubMedCrossRefGoogle Scholar
  32. 32.
    Bukte Y, Nazaroglu H, Mete A, Yilmaz F. Visceral leishmaniasis with multiple nodular lesions of the liver and spleen: CT and sonographic findings. Abdom Imaging. 2004;29(1):82–4.PubMedCrossRefGoogle Scholar
  33. 33.
    Saxena AK, Sodhi KS, Narayanan S, Singhi S, Khandelwal N. Splenic lesions in visceral leishmaniasis. Indian J Pediatr. 2011;78(6):753–4.PubMedCrossRefGoogle Scholar
  34. 34.
    Mondal S, Bhattacharya P, Ali N. Current diagnosis and treatment of visceral leishmaniasis. Expert Rev Anti-Infect Ther. 2010;8(8):919–44.PubMedCrossRefGoogle Scholar
  35. 35.
    MacPherson CN, Romig T, Zeyhle E, Rees PH, Were JB. Portable ultrasound scanner versus serology in screening for hydatid cysts in a nomadic population. Lancet. 1987;2(8553):259–61.PubMedCrossRefGoogle Scholar
  36. 36.
    Macpherson CN, Milner R. Performance characteristics and quality control of community based ultrasound surveys for cystic and alveolar echinococcosis. Acta Trop. 2003;85(2):203–9.PubMedCrossRefGoogle Scholar
  37. 37.
    Del Carpio M, Mercapide CH, Salvitti JC, Uchiumi L, Sustercic J, Panomarenko H, et al. Early diagnosis, treatment and follow-up of cystic echinococcosis in remote rural areas in Patagonia: impact of ultrasound training of non-specialists. PLoS Negl Trop Dis. 2012;6(1):e1444.PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Gharbi HA, Hassine W, Brauner MW, Dupuch K. Ultrasound examination of the hydatic liver. Radiology. 1981;139(2):459–63.PubMedCrossRefGoogle Scholar
  39. 39.
    WHO Informal Working Group on Echinococcosis. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop. 2003;85(2):253–61.CrossRefGoogle Scholar
  40. 40.
    Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114(1):1–16.PubMedCrossRefGoogle Scholar
  41. 41.
    Tamarozzi F, Nicoletti GJ, Neumayr A, Brunetti E. Acceptance of standardized ultrasound classification, use of albendazole, and long-term follow-up in clinical management of cystic echinococcosis: a systematic review. Curr Opin Infect Dis. 2014;27(5):425–31.PubMedCrossRefGoogle Scholar
  42. 42.
    Rinaldi F, Brunetti E, Neumayr A, Maestri M, Goblirsch S, Tamarozzi F. Cystic echinococcosis of the liver: a primer for hepatologists World J Hepatol. 2014;6(5):293–305Google Scholar
  43. 43.
    Filice C, Brunetti E. Use of PAIR in human cystic echinococcosis. Acta Trop. 1997;64(1–2):95–107.PubMedCrossRefGoogle Scholar
  44. 44.
    Echinococcosis. WHO IWGE: PAIR, an option for the treatment of cystic echinococcosis. WHO, Geneva 2001:40.Google Scholar
  45. 45.
    Dietrich CF, Kabaalioglu A, Brunetti E, Richter J. Fasciolosis. Z Gastroenterol. 2015;53(4):285–90.PubMedCrossRefGoogle Scholar
  46. 46.
    Kabaalioglu A, Ceken K, Alimoglu E, Saba R, Cubuk M, Arslan G, et al. Hepatobiliary fascioliasis: sonographic and CT findings in 87 patients during the initial phase and long-term follow-up. AJR Am J Roentgenol. 2007;189(4):824–8.PubMedCrossRefGoogle Scholar
  47. 47.
    Richter J, Freise S, Mull R, Millan JC. Fascioliasis: sonographic abnormalities of the biliary tract and evolution after treatment with triclabendazole. Trop Med Int Health. 1999;4(11):774–81.PubMedCrossRefGoogle Scholar
  48. 48.
    Koc Z, Ulusan S, Tokmak N. Hepatobiliary fascioliasis: imaging characteristics with a new finding. Diagn Interv Radiol. 2009;15(4):247–51.PubMedGoogle Scholar
  49. 49.
    Choi MS, Choi D, Choi MH, Ji Z, Li Z, Cho SY, et al. Correlation between sonographic findings and infection intensity in clonorchiasis. Am J Trop Med Hyg. 2005;73(6):1139–44.PubMedGoogle Scholar
  50. 50.
    Choi BI, Han JK, Hong ST, Lee KH. Clonorchiasis and cholangiocarcinoma: etiologic relationship and imaging diagnosis. Clin Microbiol Rev. 2004;17(3):540–52. Table of contents.PubMedCentralPubMedCrossRefGoogle Scholar
  51. 51.
    Mairiang E, Laha T, Bethony JM, Thinkhamrop B, Kaewkes S, Sithithaworn P, et al. Ultrasonography assessment of hepatobiliary abnormalities in 3359 subjects with Opisthorchis viverrini infection in endemic areas of Thailand. Parasitol Int. 2012;61(1):208–11.PubMedCentralPubMedCrossRefGoogle Scholar
  52. 52.
    Choi D, Jeon YH, Lee GC, Choi MH, Hong ST. Changes in sonographic findings after treatment of patients with clonorchiasis in a heavy endemic area. Korean J Parasitol. 2009;47(1):19–23.PubMedCentralPubMedCrossRefGoogle Scholar
  53. 53.
    Jeon HK, Lee D, Park H, Min DY, Rim HJ, Zhang H, et al. Human infections with liver and minute intestinal flukes in Guangxi, China: analysis by DNA sequencing, ultrasonography, and immunoaffinity chromatography. Korean J Parasitol. 2012;50(4):391–4.PubMedCentralPubMedCrossRefGoogle Scholar
  54. 54.
    Aye Soukhathammavong P, Rajpho V, Phongluxa K, Vonghachack Y, Hattendorf J, Hongvanthong B, et al. Subtle to severe hepatobiliary morbidity in Opisthorchis viverrini endemic settings in southern Laos. Acta Trop. 2015;141(Pt B):303–9.PubMedCrossRefGoogle Scholar
  55. 55.
    Homeida MA, Mackenzie CD, Williams JF, Ghalib HW. The detection of onchocercal nodules by ultrasound technique. Trans R Soc Trop Med Hyg. 1986;80(4):570–1.PubMedCrossRefGoogle Scholar
  56. 56.
    Amaral F, Dreyer G, Figueredo-Silva J, Noroes J, Cavalcanti A, Samico SC, et al. Live adult worms detected by ultrasonography in human Bancroftian filariasis. Am J Trop Med Hyg. 1994;50(6):753–7.PubMedGoogle Scholar
  57. 57.
    Mand S, Debrah AY, Klarmann U, Mante S, Kwarteng A, Batsa L, et al. The role of ultrasonography in the differentiation of the various types of filaricele due to Bancroftian filariasis. Acta Trop. 2011;120 Suppl 1:S23–32.PubMedCrossRefGoogle Scholar
  58. 58.
    Faris R, Hussain O, El Setouhy M, Ramzy RM, Weil GJ. Bancroftian filariasis in Egypt: visualization of adult worms and subclinical lymphatic pathology by scrotal ultrasound. Am J Trop Med Hyg. 1998;59(6):864–7.PubMedGoogle Scholar
  59. 59.
    Mand S, Marfo-Debrekyei Y, Dittrich M, Fischer K, Adjei O, Hoerauf A. Animated documentation of the filaria dance sign (FDS) in bancroftian filariasis. Filaria J. 2003;2(1):3.PubMedCentralPubMedCrossRefGoogle Scholar
  60. 60.
    Mand S, Debrah A, Batsa L, Adjei O, Hoerauf A. Reliable and frequent detection of adult Wuchereria bancrofti in Ghanaian women by ultrasonography. Trop Med Int Health. 2004;9(10):1111–4.PubMedCrossRefGoogle Scholar
  61. 61.
    Mand S, Supali T, Djuardi J, Kar S, Ravindran B, Hoerauf A. Detection of adult Brugia malayi filariae by ultrasonography in humans in India and Indonesia. Trop Med Int Health. 2006;11(9):1375–81.PubMedCrossRefGoogle Scholar
  62. 62.
    Darge K, Troeger J, Engelke C, Leichsenring M, Nelle M, Awadzi K, et al. Evaluation of ultrasonography for the detection of drug-induced changes in onchocercal nodules. Am J Trop Med Hyg. 1994;51(6):800–8.PubMedGoogle Scholar
  63. 63.
    Mand S, Marfo-Debrekyei Y, Debrah A, Buettner M, Batsa L, Pfarr K, et al. Frequent detection of worm movements in onchocercal nodules by ultrasonography. Filaria J. 2005;4(1):1.PubMedCentralPubMedCrossRefGoogle Scholar
  64. 64.
    Ferreyra NP, Cerri GG. Ascariasis of the alimentary tract, liver, pancreas and biliary system: its diagnosis by ultrasonography. Hepatogastroenterology. 1998;45(22):932–7.PubMedGoogle Scholar
  65. 65.
    Khuroo MS, Zargar SA, Yattoo GN, Dar MY, Javid G, Khan BA, et al. Sonographic findings in gallbladder ascariasis. J Clin Ultrasound. 1992;20(9):587–91.PubMedCrossRefGoogle Scholar
  66. 66.
    Khuroo MS, Zargar SA, Mahajan R, Bhat RL, Javid G. Sonographic appearances in biliary ascariasis. Gastroenterology. 1987;93(2):267–72.PubMedGoogle Scholar
  67. 67.
    Bahu Mda G, Baldisserotto M, Custodio CM, Gralha CZ, Mangili AR. Hepatobiliary and pancreatic complications of ascariasis in children: a study of seven cases. J Pediatr Gastroenterol Nutr. 2001;33(3):271–5.PubMedCrossRefGoogle Scholar
  68. 68.
    Mahmood T, Mansoor N, Quraishy S, Ilyas M, Hussain S. Ultrasonographic appearance of Ascaris lumbricoides in the small bowel. J Ultrasound Med. 2001;20(3):269–74.PubMedGoogle Scholar
  69. 69.
    Gonzalez AH, Regalado VC, Van den Ende J. Non-invasive management of Ascaris lumbricoides biliary tact migration: a prospective study in 69 patients from Ecuador. Trop Med Int Health. 2001;6(2):146–50.PubMedCrossRefGoogle Scholar
  70. 70.
    Baldisserotto M, Conchin CF, Soares Mda G, Araujo MA, Kramer B. Ultrasound findings in children with toxocariasis: report on 18 cases. Pediatr Radiol. 1999;29(5):316–9.PubMedCrossRefGoogle Scholar
  71. 71.
    Kabaalioglu A, Ceken K, Alimoglu E, Saba R, Apaydin A. Hepatic toxocariasis: US, CT and MRI findings. Ultraschall Med. 2005;26(4):329–32.PubMedCrossRefGoogle Scholar
  72. 72.
    Kennedy JJ, Defeo E. Ocular toxocariasis demonstrated by ultrasound. Ann Ophthalmol. 1981;13(12):1357–8.PubMedGoogle Scholar
  73. 73.
    Naveed S, Gupta V, Kapoor M, Quari H, Altaf A, Para M. Liver abscess in the tropics: an experience from Jammu. Scott Med J. 2014;59(3):167–71.PubMedCrossRefGoogle Scholar
  74. 74.
    Liu Y, Wang JY, Jiang W. An increasing prominent disease of Klebsiella pneumoniae liver abscess: etiology, diagnosis, and treatment. Gastroenterol Res Pract. 2013;2013:258514.PubMedCentralPubMedGoogle Scholar
  75. 75.
    Akinci D, Akhan O, Ozmen MN, Karabulut N, Ozkan O, Cil BE, et al. Percutaneous drainage of 300 intraperitoneal abscesses with long-term follow-up. Cardiovasc Intervent Radiol. 2005;28(6):744–50.PubMedCrossRefGoogle Scholar
  76. 76.
    Chung YF, Tan YM, Lui HF, Tay KH, Lo RH, Kurup A, et al. Management of pyogenic liver abscesses—percutaneous or open drainage? Singap Med J. 2007;48(12):1158–65. quiz 1165.Google Scholar
  77. 77.
    Egba RN, Asuquo M, Ugare GU, Udoh I. Closed drainage of liver abscesses: the ‘UNICAL’ drain as an efficient and cost saving device in a tropical setting. Niger J Clin Pract. 2008;11(4):396–9.PubMedGoogle Scholar
  78. 78.
    Erinle SA, Inikori AK. Current views on ultrasonography in the management of pyogenic liver abscess-challenge to practitioners in sub-Saharan Africa. Niger J Clin Pract. 2007;10(3):247–51.PubMedGoogle Scholar
  79. 79.
    Sharma S, Gupta HK, Chopra KK, Mahajan RK, Sharma BB, Puri M. Tubercular liver abscess: a distinct entity not to be missed. Indian J Tuberc. 2014;61(3):236–41.PubMedGoogle Scholar
  80. 80.
    Carrara E, Brunetti E, Di Matteo A, Ravetta V, Minoli L, Youkee D. Tubercular liver abscess: an uncommon presentation of disseminated tuberculosis. Infection. 2015;43(2):237–40.PubMedCrossRefGoogle Scholar
  81. 81.
    Heller T, Belard S, Wallrauch C, Carretto E, Lissandrin R, Filice C, et al. Patterns of hepatosplenic Brucella abscesses on cross-sectional imaging: a review of clinical and imaging features. Am J Trop Med Hyg. 2015;93(4):761–6.Google Scholar
  82. 82.
    Li J, Li Y, Wang Y, Huo N, Wan H, Lin X, et al. Renal abscess caused by Brucella. Int J Infect Dis. 2014;28:26–8.PubMedCrossRefGoogle Scholar
  83. 83.
    Chauhan S, Jain S, Varma S, Chauhan SS. Tropical pyomyositis (myositis tropicans): current perspective. Postgrad Med J. 2004;80(943):267–70.PubMedCentralPubMedCrossRefGoogle Scholar
  84. 84.
    Belli L, Reggiori A, Cocozza E, Riboldi L. Ultrasound in tropical pyomyositis. Skelet Radiol. 1992;21(2):107–9.CrossRefGoogle Scholar
  85. 85.
    Improving the diagnosis and treatment of smear-negative pulmonary and extrapulmonary tuberculosis among adults and adolescents. Recommendations for HIV-prevalent and resource-constrained settings. In: Geneva: World Health Organization; 2007.Google Scholar
  86. 86.
    Luzze H, Elliott AM, Joloba ML, Odida M, Oweka-Onyee J, Nakiyingi J, et al. Evaluation of suspected tuberculous pleurisy: clinical and diagnostic findings in HIV-1-positive and HIV-negative adults in Uganda. Int J Tuberc Lung Dis. 2001;5(8):746–53.PubMedGoogle Scholar
  87. 87.
    Reuter H, Burgess LJ, Doubell AF. Epidemiology of pericardial effusions at a large academic hospital in South Africa. Epidemiol Infect. 2005;133(3):393–9.PubMedCentralPubMedCrossRefGoogle Scholar
  88. 88.
    Heller T, Lessells RJ, Wallrauch C, Brunetti E. Tuberculosis pericarditis with cardiac tamponade: management in the resource-limited setting. Am J Trop Med Hyg. 2010;83(6):1311–4.PubMedCentralPubMedCrossRefGoogle Scholar
  89. 89.
    Giordani MT, Brunetti E, Binazzi R, Benedetti P, Stecca C, Goblirsch S, et al. Extrapulmonary mycobacterial infections in a cohort of HIV-positive patients: ultrasound experience from Vicenza, Italy. Infection. 2013;41(2):409–14.PubMedCrossRefGoogle Scholar
  90. 90.
    Heller T, Wallrauch C, Goblirsch S, Brunetti E. Focused assessment with sonography for HIV-associated tuberculosis (FASH): a short protocol and a pictorial review. Crit Ultrasound J. 2012;4(1):21.PubMedCentralPubMedCrossRefGoogle Scholar
  91. 91.
    dos Santos RP, Scheid KL, Willers DM, Goldani LZ. Comparative radiological features of disseminated disease due to Mycobacterium tuberculosis vs non-tuberculosis mycobacteria among AIDS patients in Brazil. BMC Infect Dis. 2008;8:24. PubMedCentralPubMedCrossRefGoogle Scholar
  92. 92.
    van Hoving DJ, Lamprecht HH, Stander M, Vallabh K, Fredericks D, Louw P, et al. Adequacy of the emergency point-of-care ultrasound core curriculum for the local burden of disease in South Africa. Emerg Med J. 2013;30(4):312–5.PubMedCrossRefGoogle Scholar
  93. 93.
    Heller T, Goblirsch S, Bahlas S, Ahmed M, Giordani MT, Wallrauch C, et al. Diagnostic value of FASH ultrasound and chest X-ray in HIV-co-infected patients with abdominal tuberculosis. Int J Tuberc Lung Dis. 2013;17(3):342–4.PubMedCrossRefGoogle Scholar
  94. 94.
    Heller T, Wallrauch C, Brunetti E, Giordani MT. Changes of FASH ultrasound findings in TB-HIV patients during anti-tuberculosis treatment. Int J Tuberc Lung Dis. 2014;18(7):837–9.PubMedCrossRefGoogle Scholar
  95. 95.
    Belard S, Heller T, Grobusch MP, Zar HJ. Point-of-care ultrasound: a simple protocol to improve diagnosis of childhood tuberculosis. Pediatr Radiol. 2014;44(6):679–80.PubMedCrossRefGoogle Scholar
  96. 96.•
    Heller T, Goblirsch S, Wallrauch C, Lessells R, Brunetti E. Abdominal tuberculosis: sonographic diagnosis and treatment response in HIV-positive adults in rural South Africa. Int J Infect Dis. 2010;14 Suppl 3:e108–12. First application of FASH concept in a highly endemic area for HIV/TB co-infection.PubMedCentralPubMedCrossRefGoogle Scholar
  97. 97.
    Vijayaraghavan SB, Kandasamy SV, Arul M, Prabhakar M, Dhinakaran CL, Palanisamy R. Spectrum of high-resolution sonographic features of urinary tuberculosis. J Ultrasound Med. 2004;23(5):585–94.PubMedGoogle Scholar
  98. 98.
    Merchant S, Bharati A, Merchant N. Tuberculosis of the genitourinary system-urinary tract tuberculosis: renal tuberculosis—part I. Indian J Radiol Imaging. 2013;23(1):46–63.PubMedCentralPubMedCrossRefGoogle Scholar
  99. 99.
    Merchant S, Bharati A, Merchant N. Tuberculosis of the genitourinary system-urinary tract tuberculosis: renal tuberculosis—part II. Indian J Radiol Imaging. 2013;23(1):64–77.PubMedCentralPubMedCrossRefGoogle Scholar
  100. 100.
    Polat Ekinci A, Karabacak E, Tekin L, Ozarmagan G, Ozcakar L. Ultrasound imaging for the follow-up of patients with leprosy: a pictorial essay. Br J Dermatol. 2015;172(1):265–7.PubMedCrossRefGoogle Scholar
  101. 101.
    Bathala L, Kumar K, Pathapati R, Jain S, Visser LH. Ulnar neuropathy in Hansen disease: clinical, high-resolution ultrasound and electrophysiologic correlations. J Clin Neurophysiol. 2012;29(2):190–3.PubMedCrossRefGoogle Scholar
  102. 102.
    Jain S, Visser LH, Yerasu MR, Raju R, Meena AK, Lokesh B, et al. Use of high resolution ultrasonography as an additional tool in the diagnosis of primary neuritic leprosy: a case report. Lepr Rev. 2013;84(2):161–5.PubMedGoogle Scholar
  103. 103.
    Rai D, Malhotra HS, Garg RK, Goel MM, Malhotra KP, Kumar V, et al. Nerve abscess in primary neuritic leprosy. Lepr Rev. 2013;84(2):136–40.PubMedGoogle Scholar
  104. 104.
    Visser LH, Jain S, Lokesh B, Suneetha S, Subbanna J. Morphological changes of the epineurium in leprosy: a new finding detected by high-resolution sonography. Muscle Nerve. 2012;46(1):38–41.PubMedCrossRefGoogle Scholar
  105. 105.
    Slim FJ, Faber WR, Maas M. The role of radiology in nerve function impairment and its musculoskeletal complications in leprosy. Lepr Rev. 2009;80(4):373–87.PubMedGoogle Scholar
  106. 106.
    Elias Jr J, Nogueira-Barbosa MH, Feltrin LT, Furini RB, Foss NT, Marques Jr W, et al. Role of ulnar nerve sonography in leprosy neuropathy with electrophysiologic correlation. J Ultrasound Med. 2009;28(9):1201–9.PubMedGoogle Scholar
  107. 107.
    Tshibwabwa ET, Mwaba P, Bogle-Taylor J, Zumla A. Four-year study of abdominal ultrasound in 900 Central African adults with AIDS referred for diagnostic imaging. Abdom Imaging. 2000;25(3):290–6.PubMedCrossRefGoogle Scholar
  108. 108.
    Brunetti E, Brigada R, Poletti F, Maiocchi L, Garlaschelli AL, Gulizia R, et al. The current role of abdominal ultrasound in the clinical management of patients with AIDS. Ultraschall Med. 2006;27(1):20–33.PubMedCrossRefGoogle Scholar
  109. 109.
    Keane MA, Finlayson C, Joseph AE. A histological basis for the ‘sonographic snowstorm’ in opportunistic infection of the liver and spleen. Clin Radiol. 1995;50(4):220–2.PubMedCrossRefGoogle Scholar
  110. 110.
    Waheed S, Atta MG. Predictors of HIV-associated nephropathy. Expert Rev Anti-Infect Ther. 2014;12(5):555–63.PubMedCrossRefGoogle Scholar
  111. 111.
    Colbert JA, Gordon A, Roxelin R, Silva S, Silva J, Rocha C, et al. Ultrasound measurement of gallbladder wall thickening as a diagnostic test and prognostic indicator for severe dengue in pediatric patients. Pediatr Infect Dis J. 2007;26(9):850–2.PubMedCrossRefGoogle Scholar
  112. 112.
    Oliveira GA, Machado RC, Horvat JV, Gomes LE, Guerra LR, Vandesteen L, et al. Transient reticular gallbladder wall thickening in severe dengue fever: a reliable sign of plasma leakage. Pediatr Radiol. 2010;40(5):720–4.PubMedCrossRefGoogle Scholar
  113. 113.
    Bharath Kumar Reddy KR, Laksmana RR, Veerappa BG, Shivananda. Ultrasonography as a tool in predicting the severity of dengue fever in children—a useful aid in a developing country. Pediatr Radiol. 2013;43(8):971–7.PubMedCrossRefGoogle Scholar
  114. 114.
    Srikiatkhachorn A, Krautrachue A, Ratanaprakarn W, Wongtapradit L, Nithipanya N, Kalayanarooj S, et al. Natural history of plasma leakage in dengue hemorrhagic fever: a serial ultrasonographic study. Pediatr Infect Dis J. 2007;26(4):283–90Google Scholar
  115. 115.
    Arshad K, Sheikh S, Naqvi SU, Sarwar I, Javaid S, Asghar M, et al. Frequency of splenomegaly in dengue fever in children. J Ayub Med Coll Abbottabad. 2015;27(2):356–9.PubMedGoogle Scholar
  116. 116.••
    Michels M, Sumardi U, de Mast Q, Jusuf H, Puspita M, Dewi IM, et al. The predictive diagnostic value of serial daily bedside ultrasonography for severe dengue in Indonesian adults. PLoS Negl Trop Dis. 2013;7(6):e2277. Prospective observational study shows serial bedside US is better at identifying patients at risk for severe dengue than existing markers such as hematocrit.PubMedCentralPubMedCrossRefGoogle Scholar
  117. 117.••
    Reissig A, Copetti R, Mathis G, Mempel C, Schuler A, Zechner P, et al. Lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia: a prospective, multicenter, diagnostic accuracy study. Chest. 2012;142(4):965–72. Prospective study shows that sensitivity and specificity of lung US in the diagnosis of community acquired pneumonia are at least comparable with chest radiograph in two planes.PubMedCrossRefGoogle Scholar
  118. 118.•
    Chavez MA, Shams N, Ellington LE, Naithani N, Gilman RH, Steinhoff MC, et al. Lung ultrasound for the diagnosis of pneumonia in adults: a systematic review and meta-analysis. Respir Res. 2014;15:50. Meta-analysis supports good performance of lung US in the diagnosis of pneumonia in adults PubMedCentralPubMedCrossRefGoogle Scholar
  119. 119.
    Sperandeo M, Carnevale V, Muscarella S, Sperandeo G, Varriale A, Filabozzi P, et al. Clinical application of transthoracic ultrasonography in inpatients with pneumonia. Eur J Clin Investig. 2011;41(1):1–7.CrossRefGoogle Scholar
  120. 120.
    Sperandeo M, Filabozzi P, Varriale A, Carnevale V, Piattelli ML, Sperandeo G, et al. Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases. J Ultrasound. 2008;11(2):39–46.PubMedCentralPubMedCrossRefGoogle Scholar
  121. 121.
    Ding W, Shen Y, Yang J, He X, Zhang M. Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis. Chest. 2011;140(4):859–66.PubMedCrossRefGoogle Scholar
  122. 122.
    Ianniello S, Di Giacomo V, Sessa B, Miele V. First-line sonographic diagnosis of pneumothorax in major trauma: accuracy of e-FAST and comparison with multidetector computed tomography. Radiol Med. 2014;119(9):674–80.PubMedCrossRefGoogle Scholar
  123. 123.
    Al Deeb M, Barbic S, Featherstone R, Dankoff J, Barbic D. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21(8):843–52.PubMedCrossRefGoogle Scholar
  124. 124.
    Belard S, Tamarozzi F, Bustinduy AL, Wallrauch C, Grobusch MP, Kuhn W, et al. Point-of-care ultrasound assessment of tropical infectious diseases—a review of applications and perspectives. Am J Trop Med Hyg. 2015.Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Enrico Brunetti
    • 1
    • 2
    Email author
  • Tom Heller
    • 3
  • Joachim Richter
    • 4
  • Daniel Kaminstein
    • 5
  • Daniel Youkee
    • 6
  • Maria Teresa Giordani
    • 7
  • Samuel Goblirsch
    • 8
  • Francesca Tamarozzi
    • 2
  1. 1.Department of Infectious DiseasesSan Matteo Hospital FoundationPaviaItaly
  2. 2.Department of Clinical, Surgical, Diagnostic and Pediatric SciencesUniversity of PaviaPaviaItaly
  3. 3.Department of MedicineKlinikum Muenchen-PerlachMunichGermany
  4. 4.Tropical Medicine, Clinic of Gastroenterology, Hepatology and Infectious DiseasesHeinrich-Heine UniversityDüsseldorfGermany
  5. 5.Department of Emergency Medicine and Hospitalist Services, Medical College of GeorgiaAugusta UniversityAugustaUSA
  6. 6.King’s College HospitalLondonUK
  7. 7.Infectious and Tropical Diseases UnitSan Bortolo HospitalVicenzaItaly
  8. 8.Minneapolis Veterans Affairs HospitalMinneapolisUSA

Personalised recommendations