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J Ultrasound. 2019 Mar 9. doi: 10.1007/s40477-019-00371-8. [Epub ahead of print]

Is there a role for bedside ultrasound in malaria? A survey of the literature.

Author information

1
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100, Pavia, PV, Italy.
2
Department of Emergency Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia.
3
Department of Infectious Diseases, IRCCS Policlinico San Matteo Hospital Fundation, Pavia, Italy.
4
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100, Pavia, PV, Italy. tommaso.manciulli01@ateneopv.it.
5
PhD School of Experimental Medicine, University of Pavia, Pavia, Italy. tommaso.manciulli01@ateneopv.it.

Abstract

PURPOSE:

Point-of-care ultrasound (POCUS) has proven utility in the evaluation and treatment of many tropical diseases. Its role in malaria has been studied, but its value for the clinician at the bedside is unclear. Our review aimed at summarizing the existing studies to assess the usefulness, if any, of POCUS in treating malaria.

METHODS:

We used Boolean operators using keywords "malaria", "acoustic", "ultrasound", "echography", and "ultrasonography" to search PubMed, Scopus, and Science Direct in three languages (Italian, French, and English).

RESULTS:

We found 22 eligible references. Organs explored include the liver, spleen, heart, optic nerve sheath diameter (ONSD), kidney, lungs, and cerebral vasculature. Multiple pathologic findings by ultrasound are reported, but few demonstrate clinical utility. Current studies involve small numbers of patients, and a few trends emerge when studies are compared. The ability to combine study results is limited due to the significant heterogeneity that exists between studies in regards to both methods of evaluation and the reporting of organ pathology and malaria severity.

CONCLUSIONS AND ASSESSMENT:

A review of the current literature indicates that the use of ultrasound by clinicians adds little to the diagnostic evaluation of patients with malaria. Our review did find that measurements of the spleen, lungs, optic nerve sheath diameter, and cerebral blood flow have potential utility in specific patient populations. Further studies are needed to evaluate whether this utility persists when a larger sample size is used.

KEYWORDS:

Cerebral malaria; Diagnosis; Malaria; Ultrasound

PMID:
30852774
DOI:
10.1007/s40477-019-00371-8

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