%0 Journal Article
%T Focused assessment with sonography for HIV-associated tuberculosis (FASH): a short protocol and a pictorial review
%A Tom Heller
%A Claudia Wallrauch
%A Sam Goblirsch
%A Enrico Brunetti
%J Critical Ultrasound Journal
%D 2012
%I BioMed Central
%R 10.1186/2036-7902-4-21
%X A protocol for focused assessment with sonography for HIV-associated tuberculosis (FASH) which can be used by physicians who are relatively inexperienced in ultrasound was developed.The technique as well as normal and pathological findings are described and the diagnostic and possible therapeutic reasoning explained. The protocol is intended for settings where the prevalence of HIV/TB co-infected patients is high.FASH is suitable for more rapid identification of EPTB even at the peripheral hospital level where other imaging modalities are scarce and most of the HIV and TB care will be delivered in the future.In sub-Saharan Africa, the convergence of human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics has led to a resurgence of extrapulmonary TB (EPTB). EPTB accounts for 15% to 20% of all TB cases reported by TB control programs in the African region [1]. Diagnosis is hampered by the difficulty to obtain material, poor sensitivity of microscopy, and the limited availability of culture techniques. Consequently, the diagnosis is usually based on clinical case definitions [2].Common manifestations of EPTB include pericardial effusion, pleural effusion, and abdominal TB. Tuberculous pericarditis is consistently reported as the predominant cause of pericardial effusion in Southern Africa and is in most of the cases associated with HIV co-infection [3]. Cardiac tamponade is the most severe clinical presentation of TB pericarditis and constitutes a life threatening event that requires immediate medical intervention [4]. Pleural effusion, especially when unilateral and associated with HIV infection, is most likely to be caused by tuberculosis in countries with a high TB incidence [5]. Typical ultrasound (US) findings of abdominal TB include retroperitoneal and mesenteric lymphadenopathy with node diameter greater than 1.5 cm, multiple splenic hypoechoic nodules between 0.5 and 1 cm, and patterns of ascites [6].Ultrasound (US) can rapidly identify abnormal sign
%K HIV
%K TB
%K Co-infection
%K Ultrasound
%K Focused assessment
%K Resource-limited setting.
%U http://www.criticalultrasoundjournal.com/content/4/1/21