A new exam suitable for rapid identification of extrapulmonary TB
Submitted by Dr. Laura Diegelmann
Additional Information
The majority of HIV-TB co-infection cases (78%) are reported in sub-Saharan Africa.
Extra-pulmonary TB risk increases as immune deficiency progresses.
Ultrasonography can be helpful in identifying extra-pulmonary TB-associated findings in the patient with HIV.
The FASH exam (Focused Assessment with Sonography for HIV/TB).
20% of all TB is extrapulmonary TB (EPTB).
High percent of these patients have sputum negative smears for mycobacterium.
In the setting of advanced HIV the diagnosis of EPTB may be difficult do to atypical clinical presentations, undiagnosed HIV and infection at occult sights where sputum testing will be negative.
Rational for FAST exam-
Expedite diagnosis
Earlier initiation of TB treatment which improves M&M
References
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 2012;4:21
Heller T, Wallrauch C, Lessells RJ, Goblirsch S, Brunetti E. Short report: Short course for Focused Assessment with Sonography for HIV/TB: Preliminary Results in a Rural Setting in South Africa with High Prevalence of HIV and TB. Am J Trop Med Hyg. 2010;82:512-5.
