Ultrasound in Resource-Limited Settings: A Case Based, Open Access Text

Editors-in-Chief: Michael Schick DO and Rebecca Stein-Wexler MD. On-line Editor Aida Nasirishargh.

An online, open source book focusing on ultrasound in tropical medicine and resource-limited environments. Our goal is to create an up-to-date and useful resource for those taking care of vulnerable patients around the globe.

Sections

Head

  • Cover of Focal Seizure and Use of Optic Nerve Sheath Diameter

    Focal Seizure and Use of Optic Nerve Sheath Diameter

    by Charles McElyea MD, Michael Schick DO

    A 7-year-old female presented to the Emergency Department in status epilepticus...

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  • Cover of Infantile Beriberi

    Infantile Beriberi

    by Kirsten Douglass MD, Rebecca Stein-Wexler MD

    5-month-old Laotian female presented with intractable vomiting. She was exclusively breastfed, and her mother followed the Hmong postpartum restrictive diet of eating predominantly polished white rice...

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  • Cover of Hydrocephalus

    Hydrocephalus

    by Stephen Vong MD, Rebecca Stein-Wexler MD

    Term infant born via cesarean section for breech presentation and hypoglycemia, found to have macrocephaly...

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  • Cover of Meningitis

    Meningitis

    by Rebecca Stein-Wexler MD

    A 1-month premature infant presented with rhythmic jerking of all 4 extremities at age six weeks...

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  • Cover of Pediatric Skull Fractures

    Pediatric Skull Fractures

    by Victoria Shin DO, Michael Schick DO

    An 18-month-old boy is brought into a rural emergency department in Uganda by his mother who states he has had abnormal irritability and fussiness for the past 2-3 hours. At home, he entered the residence crying and holding the right side of his head...

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Echocardiography

  • Cover of Aortic Dissection

    Aortic Dissection

    by Papa Kojo Mbroh MD, Chris Oppong MD, Ideen Zeinali MD

    A 66-year-old male with a past medical history of congestive heart failure (CHF) presents to Komfo Anokye Teaching Hospital (KATH) for evaluation of worsening shortness of breath on exertion and vague abdominal discomfort...

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  • Cover of Peripartum Cardiomyopathy

    Peripartum Cardiomyopathy

    by Albert Mugisa, Deus Twinomugisha ECP, Tracy Walczynski MD, Michael Schick DO

    Two sisters presented to the Emergency Department (ED) with concerns that their abdomens were increasing after giving birth...

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  • Cover of Pulmonary Embolism

    Pulmonary Embolism

    by Ideen Zeinali MD, Matthew Edwards

    A 58-year-old African female presented to Komfo Anoyke Teach Hospital in Kumasi, Ghana for evaluation of recent right lower extremity swelling, sudden onset breathlessness, and easy fatigability...

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  • Cover of Rheumatic Heart Disease

    Rheumatic Heart Disease

    by Quraish Fazleabas DO, Niwagaba Benifer ECP, Joseph Leanza MD

    A 28-year-old Ugandan man has had a many-month history of progressive exercise intolerance and orthopnea. He did not seek care, but volunteered to model for an ultrasound training session...

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  • Cover of Tropical Endomyocardial Fibrosis

    Tropical Endomyocardial FibrosisFollowed by a case of Endomyocardial Fibrosis by Christine McBeth, DO, MSPH

    by Nikolai Schnittke MD, PhD, Rosalia Holzman MD, Sarah Eragu MBChB

    A 45-year-old male arrives to our mobile clinic after walking from his village 20km away with three days of a worsening fever, myalgias, and fatigue. He has not eaten in 48 hours. The walk from his village proved extremely difficult for him and he noted also feeling mildly dyspneic...

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  • Cover of Tuberculosis Pericarditis

    Tuberculosis Pericarditis

    by R. Wahome MD, D. Mirsch DO

    A 61-year-old male presents for difficulty breathing. His current illness began with a low grade, non-productive cough associated with mild chest pain, night sweats and significant weight loss over the past two months...

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Pulmonary

  • Cover of Cavitary Lesion of the Lung

    Cavitary Lesion of the Lung

    by Christine McBeth DO

    A 25-year-old male with past medical history of HIV presents with shortness of breath and fevers for three days...

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  • Cover of Pneumocystis Pneumonia

    Pneumocystis Pneumonia

    by Travis Kling MD, Albert Mugisa, Michael Schick DO

    A 28-year-old female presents with rapidly progressive chest pain and shortness of breath over the past two days...

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  • Cover of Lobar Pneumonia

    Lobar Pneumonia

    by Travis Kling MD, Michael Schick DO

    A partially-vaccinated 6-year-old female with no significant past medical history presents to a district emergency department in rural Uganda. Her mother reports that she has had 4 days of progressively worsening cough and appears to have difficulty breathing at times...

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  • Cover of Shortness of Breath at the South Pole

    Shortness of Breath at the South Pole

    by Ellen Asselin MD, John Rose MD

    23-year-old male with no significant medical history presents with severe shortness of breath at rest. He arrived at the Amundsen-Scott South Pole station three days prior...

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  • Cover of Undifferentiated Dyspnea in the Era of COVID

    Undifferentiated Dyspnea in the Era of COVIDFollowed by a case of COVID-19 by Yale Tung-Chen, MD PhD

    by Rio Beardsley MD, Peter Weimersheimer MD, Katie Wells MD, MPH

    A 45-year-old male arrives to our mobile clinic after walking from his village 20km away with three days of a worsening fever, myalgias, and fatigue...

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Abdomen

  • Cover of Amoebic Liver Abscess

    Amoebic Liver Abscess

    by Romeo Wahome MD, Daniel Mirsch DO

    A 24-year-old female presents to an emergency department in southern Uganda with a chief complaint of three weeks of night sweats. Her symptoms progressed gradually with increasing abdominal pain, localized to the right upper quadrant...

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  • Cover of Appendico-cecocolic Intussusception

    Appendico-cecocolic Intussusception

    by Anamika Jha MD, Sasmita Tuladhar MD, Bishnu Gautam MD

    A 4-year-old boy presented with 4 days of intermittent abdominal pain and vomiting. There was no history of bloody diarrhea, constipation, or fever. No significant past medical or surgical history...

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  • Cover of Ascariasis

    Ascariasis

    by Wayne Fu MD, Josh Greenstein MD, Amit Ramjit MD

    7-year-old male presented with fever and diarrhea, worsening diffuse abdominal pain and weight loss over the past 2 weeks after traveling from Honduras 3 weeks ago...

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  • Cover of Echinococcus Granulosus Hydatid Cyst

    Echinococcus Granulosus Hydatid Cyst

    by Danielle Langan DO, Josh Greenstein MD, Barry Hahn MD

    A 69-year-old female with a history of hypertension presented to the emergency department with malaise, right upper quadrant pain, and nausea intermittently for two months, worsening over the past three days...

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  • Cover of Hyper-reactive Malarial Splenomegaly

    Hyper-reactive Malarial Splenomegaly

    by Amanda Ferguson MD, Rebecca Stein-Wexler MD

    A 19-year-old male who has just emigrated from Papua New Guinea to the United States presents for evaluation to his primary care provider for an abdominal pain and swelling as well as weight loss...

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  • Cover of Liver Biopsy in Hepatocellular Carcinoma

    Liver Biopsy in Hepatocellular Carcinoma

    by Amir Sultan MD

    A 45-year-old farmer from rural Ethiopia presented with a 5-month history of progressive right upper quadrant pain accompanied by a dragging sensation and loss of appetite. He had no history of bleeding, change in mentation or other illness...

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  • Cover of Midgut Volvulus

    Midgut Volvulus

    by Kristopher de Ga MD, Rebecca Stein-Wexler MD

    An otherwise healthy 10-month-old female presents with 1 day of bilious emesis and fussiness...

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  • Cover of Perforated Appendicitis

    Perforated Appendicitis

    by Stephen Vong MD, Rebecca Stein-Wexler MD

    A 5-year-old boy with no past medical history presented with fever and abdominal pain. One week prior, he had one episode of large volume emesis and periumbilical pain...

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  • Cover of Small Bowel Obstruction and Pneumatosis Intestinalis

    Small Bowel Obstruction and Pneumatosis IntestinalisFollowed by a case of Small Bowel Obstruction by Ideen Zeinali, MD and Matthew Edwards

    by Ryan Gibbons MD

    A 54-year-old African American male presented to the emergency department (ED) complaining of 3 days of diffuse abdominal pain, obstipation, and intermittent non-bilious, non-bloody emesis...

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  • Cover of Small Bowel Obstruction due to Intestinal Tuberculosis

    Small Bowel Obstruction due to Intestinal Tuberculosis

    by Jonathan F Swanson MD, Akinniyi E Fadipe MCS (ECSA), Samuel L Burleson MD

    A 37-year old male on intensive phase tuberculosis (TB) treatment presents with 3-day history of generalized moderate abdominal pain and loss of appetite. Reported passage of small amounts of stool. No history of fever...

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  • Cover of Strangulated Umbilical Hernia

    Strangulated Umbilical Hernia

    by Jimmy Ford MD, Michael Schick DO

    A 22-year-old male presents with abdominal pain to a district hospital in rural Uganda. The pain began this morning at the site of an unrepaired umbilical hernia, which has gradually worsened and has now spread to his whole abdomen...

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  • Cover of Typhoid Intestinal Perforation

    Typhoid Intestinal Perforation

    by Kevin Xerxes Durgun MD, Michael Schick DO

    A 14-year-old male who lives in rural Uganda, presented to Masaka Regional Referral Hospital with 3 days of high-grade fever, constipation, and severe abdominal pain...

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  • Cover of Ultrasound-guided Reduction of Intussusception

    Ultrasound-guided Reduction of Intussusception

    by Jennifer LaRoy MD, Rebecca Stein-Wexler MD

    A 2-year-old male with no significant past medical history presented with abdominal pain. Pain was episodic and had increased in frequency over the course of a day...

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Female Genitourinary

  • Cover of Necrotizing Endomyometritis

    Necrotizing Endomyometritis

    by Vincent Ndebwanimana, Ling Jing, Uwamahoro Doris

    An 18-year-old previously healthy female consulted for progressively increasing abdominal distension, pain, vomiting, and weakness...

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  • Cover of Ruptured Ectopic Pregnancy

    Ruptured Ectopic PregnancyFAST

    by Freshta Sahak MD

    A 25-year-old female with no significant past medical history presents to a regional referral emergency department in Uganda with one day of sudden onset diffuse abdominal pain, worse in the lower abdomen...

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Male Genitourinary

  • Cover of Fournier's Gangrene

    Fournier's Gangrene

    by Romeo Wahome MD, Daniel Mirsch DO

    70-year-old man with HIV (compliant with HAART for over 5 years) with a recent surgical admission (10 days prior) for testicular hydrocelectomy, presented to the emergency department with scrotal pain for 1 week and associated fever for 5 days...

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  • Cover of Lymphatic Filariasis

    Lymphatic Filariasis

    by Benjamin Verseman MD, Michael Schick DO

    A 30-year-old male presents with bilateral testicular discomfort slowly progressing over 4 weeks. He also states he noticed slight increase in the size of his bilateral testicles...

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Musculoskeletal

  • Cover of Subperiosteal Abscess

    Subperiosteal Abscess

    by Kristopher de Ga MD, Rebecca Stein-Wexler MD

    15-year-old male with sickle cell disease presents with acute-onset severe pain in his lower back and bilateral lower extremities. He has noticed swelling of his extremities for the past few days and has experienced fatigue and subjective fever for 1 week...

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  • Cover of Supracondylar Fracture

    Supracondylar Fracture

    by Averyl Shindruk MD, Michael Schick DO

    A previously healthy 6-year-old girl presents with a chief complaint of right arm pain after a witnessed fall while running...

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  • Cover of Tropical Pyomyositis

    Tropical Pyomyositis

    by Navneet Dhillon MD, Michael Schick DO

    A 6-year-old boy presents to an emergency department in Northern Laos with a 2-week history of right leg pain...

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Soft Tissue

  • Cover of Human Dirofilariasis

    Human Dirofilariasis

    by Amanda Ferguson MD, Rebecca Stein-Wexler MD

    A 45-year-old male with a history of HIV presented with a three-week history of a painless subcutaneous nodule in his left forearm...

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  • Cover of Necrotizing Soft Tissue Infection

    Necrotizing Soft Tissue Infection

    by Ryan Gibbons MD

    A 64-year-old African American male with a history of insulin dependent diabetes mellitus and hypertension presented to the emergency department with atraumatic right foot pain, swelling, and drainage for 1 week...

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Systemic Diseases

  • Cover of Dengue

    DengueFollowed by a case of Dengue Fever by Michelle Sin Lee, MDCM & Jade Seguin, MDCM

    by Melissa Myers MD, MS Erin Jacobs

    An 8-month-old female with no known medical history was brought to an Emergency Department in San Pedro Sula, Honduras with fever and decreased oral intake...

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  • Cover of Miliary Tuberculosis

    Miliary Tuberculosis

    by Jordan Rode MD, Melony Chakrabarty MD, Michael Schick DO

    A 35-year-old previously healthy Ugandan male, presents with cough for 3-4 months, dark sputum and intermittent fevers. The cough has been constant, and sputum production is thickening...

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Vascular

  • Cover of Arterial-Venous Fistula: An A&E case from Masaka, Uganda

    Arterial-Venous Fistula: An A&E case from Masaka, Uganda

    by Leigha Winters MD

    A 20-year-old male with no significant past medical history presented to the Accident and Emergency (A&E) department with proximal right forearm swelling for 1-2 months. The patient was sent in by a radiologist for reported forearm abscess seen on outside imaging, with recommendations for incision and drainage...

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