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-
1.
World Health Organization , 2019. Second WHO Model List of Essential In Vitro Diagnostics. Available at: https://www.who.int/docs/default-source/nutritionlibrary/complementary-feeding/second-who-model-list-v8-2019.pdf?sfvrsn=6fe86adf_1. Accessed September 19, 2022.
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2.
Kaminstein D , Heller T , Tamarozzi F , 2019. Sound around the world: ultrasound for tropical diseases. Infect Dis Clin North Am 33: 169–195.
-
3.
Bélard S , Tamarozzi F , Bustinduy AL , Wallrauch C , Grobusch MP , Kuhn W , Brunetti E , Joekes E , Heller T , 2016. Point-of-care ultrasound assessment of tropical infectious diseases – a review of applications and perspectives. Am J Trop Med Hyg 94: 8–21.
-
4.
Heller T , Wallrauch C , Goblirsch S , Brunetti E , 2012. Focused assessment with sonography for HIV-associated tuberculosis (FASH): a short protocol and a pictorial review. Crit Ultrasound J 4: 21.
-
5.
Griesel R , Cohen K , Mendelson M , Maartens G , 2019. Abdominal ultrasound for the diagnosis of tuberculosis among human immunodeficiency virus-positive inpatients with World Health Organization danger signs. Open Forum Infect Dis 6: ofz094.
-
6.
Heller T , Mtemang’ombe EA , Huson MA , Heuvelings CC , Bélard S , Janssen S , Phiri S , Grobusch MP , 2017. Ultrasound for patients in a high HIV/tuberculosis prevalence setting: a needs assessment and review of focused applications for sub-Saharan Africa. Int J Infect Dis 56: 229–236.
-
7.
Akram SM , Anwar MY , Thandra KC , Rawla P , 2022. Bacillary Angiomatosis. Treasure Island, FL: StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK448092/. Accessed September 19, 2022.
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8.
Chelidze K , Thomas C , Chang AY , Freeman EE , 2019. HIV-related skin disease in the era of antiretroviral therapy: recognition and management. Am J Clin Dermatol 20: 423–442.
-
9.
Kaminstein D , 2020. Point-of-care ultrasound for tropical disease: implications for clinical decision-making. Am J Trop Med Hyg 103: 542–543.
-
10.
Heller T , Bélard S , Wallrauch C , Carretto E , Lissandrin R , Filice C , Brunetti E , 2015. Patterns of hepatosplenic Brucella abscesses on cross-sectional imaging: a review of clinical and imaging features. Am J Trop Med Hyg 93: 761–766.
-
11.
Huson MAM , Kling K , Chankongsin S , Phongluxa K , Keoluangkhot V , Newton PN , Dance D , Heller T , Neumayr A , 2020. Point-of-care ultrasound in the diagnosis of melioidosis in Laos. Am J Trop Med Hyg 103: 675–678.
-
12.
Bélard S , Stratta E , Zhao A , Ritmeijer K , Moretó-Planas L , Fentress M , Nadimpalli A , Grobusch MP , Heller T , Heuvelings CC , 2021. Sonographic findings in visceral leishmaniasis – a narrative review. Travel Med Infect Dis 39: 101924.
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13
Braden B , Helm B , Fabian T , Dietrich CF , 2000. Bazilläre Angiomatose der Leber, eine sonographische Verdachtsdiagnose? [Bacillary angiomatosis of the liver, a suspected ultrasound diagnosis?]. Z Gastroenterol 38: 785–789.
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14.
Heller T et al., 2022. Implementing advanced HIV disease care for inpatients in a referral hospital in Malawi – demand, results and cost implications. Ann Glob Health 88: 16.
| Past two years | Past Year | Past 30 Days | |
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Case Report: Role of Point-of-Care Ultrasound in the Diagnosis of Bacillary Angiomatosis
Giacomo Stroffolini
Giacomo Stroffolini
Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy;
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Kelvin Rambiki
Kelvin Rambiki
Lighthouse Clinic Trust, Lilongwe, Malawi;
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Claudia Wallrauch
Claudia Wallrauch
Lighthouse Clinic Trust, Lilongwe, Malawi;
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Tamiwe Tomoka
Tamiwe Tomoka
Pathology Lab, University of North Carolina School of Medicine, Lilongwe, Malawi;
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Enrico Brunetti
Enrico Brunetti
Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Immunology and Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy;
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Tom Heller
Tom Heller
Lighthouse Clinic Trust, Lilongwe, Malawi;
International Training and Education Center for Health, University of Washington, Seattle, Washington
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International Training and Education Center for Health, University of Washington, Seattle, Washington
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ABSTRACT.
Clinical skin manifestations are commonly seen in resource-limited settings, but they are frequently misdiagnosed due to the lack of microbiological tests with ensuing stigma and long-term disability. The adoption of portable ultrasound devices, which extend physical examination in the hands of trained clinicians, has partially improved the situation. Specific protocols, such as focused assessment with sonography for HIV-associated tuberculosis (FASH), have led to simplified diagnostic pathways. Here we describe a case of bacillary angiomatosis in a patient with advanced HIV disease presenting with subacute unusual cutaneous lesions. The patient also presented with significant weight loss, anemia, and prostration. Highly sensitive rapid tests for tuberculosis and cryptococcosis were negative, and CD4 count was very low. Ultrasound scanning (US) and biopsy of the cutaneous lesions finally led to diagnosis and treatment. This report illustrates the benefits of integrating ultrasound-based protocols with clinical skills, as the diagnosis was suspected based on clinical presentation and US and confirmed by pathology. The importance of adoption of US protocols by infectious diseases clinicians is discussed.
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Author Notes
Disclosure: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from the patient’s relatives for publication of case history and anonymized images.
Authors’ addresses: Giacomo Stroffolini, Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy, E-mail: giacomo.stroffolini@sacrocuore.it. Kelvin Rambiki and Claudia Wallrauch, Lighthouse Clinic Trust, Lilongwe, Malawi, E-mails: krambiki@lighthouse.org.mw and cwallrauch@lighthouse.org.mw. Tamiwe Tomoka, Pathology Lab, University of North Carolina School of Medicine, Lilongwe, Malawi, E-mail: ttomoka@unclilongwe.org. Enrico Brunetti, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Immunology and Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy, E-mail: enrico.brunetti@unipv.it. Tom Heller, Lighthouse Clinic Trust, Lilongwe, Malawi, and International Training and Education Center for Health, University of Washington, Seattle, WA, E-mail: theller@lighthouse.org.mw.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization , 2019. Second WHO Model List of Essential In Vitro Diagnostics. Available at: https://www.who.int/docs/default-source/nutritionlibrary/complementary-feeding/second-who-model-list-v8-2019.pdf?sfvrsn=6fe86adf_1. Accessed September 19, 2022.
-
2.
Kaminstein D , Heller T , Tamarozzi F , 2019. Sound around the world: ultrasound for tropical diseases. Infect Dis Clin North Am 33: 169–195.
-
3.
Bélard S , Tamarozzi F , Bustinduy AL , Wallrauch C , Grobusch MP , Kuhn W , Brunetti E , Joekes E , Heller T , 2016. Point-of-care ultrasound assessment of tropical infectious diseases – a review of applications and perspectives. Am J Trop Med Hyg 94: 8–21.
-
4.
Heller T , Wallrauch C , Goblirsch S , Brunetti E , 2012. Focused assessment with sonography for HIV-associated tuberculosis (FASH): a short protocol and a pictorial review. Crit Ultrasound J 4: 21.
-
5.
Griesel R , Cohen K , Mendelson M , Maartens G , 2019. Abdominal ultrasound for the diagnosis of tuberculosis among human immunodeficiency virus-positive inpatients with World Health Organization danger signs. Open Forum Infect Dis 6: ofz094.
-
6.
Heller T , Mtemang’ombe EA , Huson MA , Heuvelings CC , Bélard S , Janssen S , Phiri S , Grobusch MP , 2017. Ultrasound for patients in a high HIV/tuberculosis prevalence setting: a needs assessment and review of focused applications for sub-Saharan Africa. Int J Infect Dis 56: 229–236.
-
7.
Akram SM , Anwar MY , Thandra KC , Rawla P , 2022. Bacillary Angiomatosis. Treasure Island, FL: StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK448092/. Accessed September 19, 2022.
-
8.
Chelidze K , Thomas C , Chang AY , Freeman EE , 2019. HIV-related skin disease in the era of antiretroviral therapy: recognition and management. Am J Clin Dermatol 20: 423–442.
-
9.
Kaminstein D , 2020. Point-of-care ultrasound for tropical disease: implications for clinical decision-making. Am J Trop Med Hyg 103: 542–543.
-
10.
Heller T , Bélard S , Wallrauch C , Carretto E , Lissandrin R , Filice C , Brunetti E , 2015. Patterns of hepatosplenic Brucella abscesses on cross-sectional imaging: a review of clinical and imaging features. Am J Trop Med Hyg 93: 761–766.
-
11.
Huson MAM , Kling K , Chankongsin S , Phongluxa K , Keoluangkhot V , Newton PN , Dance D , Heller T , Neumayr A , 2020. Point-of-care ultrasound in the diagnosis of melioidosis in Laos. Am J Trop Med Hyg 103: 675–678.
-
12.
Bélard S , Stratta E , Zhao A , Ritmeijer K , Moretó-Planas L , Fentress M , Nadimpalli A , Grobusch MP , Heller T , Heuvelings CC , 2021. Sonographic findings in visceral leishmaniasis – a narrative review. Travel Med Infect Dis 39: 101924.
-
13
Braden B , Helm B , Fabian T , Dietrich CF , 2000. Bazilläre Angiomatose der Leber, eine sonographische Verdachtsdiagnose? [Bacillary angiomatosis of the liver, a suspected ultrasound diagnosis?]. Z Gastroenterol 38: 785–789.
-
14.
Heller T et al., 2022. Implementing advanced HIV disease care for inpatients in a referral hospital in Malawi – demand, results and cost implications. Ann Glob Health 88: 16.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1143 | 513 | 28 |
| Full Text Views | 826 | 220 | 1 |
| PDF Downloads | 109 | 38 | 1 |