12/2/2023 0 Comments Scleral icterus![]() She has worked in the developing world for the past 21 years and completed the Gorgas Diploma Course in Clinical Tropical Medicine. SJD has served as the Pediatric Ultrasound Subcommittee chair of ACEP and on the Board of Directors of WINFOCUS. She has lectured and directed pediatric POCUS courses worldwide and has developed her own ultrasound divisions and fellowships. ![]() SJD is an international leader in the fields of pediatric emergency medicine and pediatric point-of-care ultrasound (POCUS). Both authors read and approved the final manuscript. AW contributed to researching background literature and assisted in writing the body of the manuscript. SJD performed the ultrasonography, obtained images, and devised this report. Point-of-care ultrasound may be the only imaging modality available, and it is therefore crucial to becoming familiar with normal findings, tropical infectious diseases, and some of the rarer pathology seen in these practice settings. It is particularly important for clinicians practicing in resource-limited settings to maintain broad differential diagnoses and integrate the POCUS examination with history and physical examination findings and laboratory studies (if available). As an alternative, POCUS can facilitate diagnoses at the bedside and ultimately make a significant impact on management decisions. There are often significant delays and prohibitive costs associated with advanced imaging studies, such as computerized tomography and magnetic resonance imaging. Point-of-care ultrasound can be particularly useful in resource-limited practice settings, such as in the developing world. Since that time, its use has become more widespread, extending across other subspecialties and into other practice environments. Point-of-care ultrasound (POCUS) was first introduced in the emergency department in the 1980s. It is important for the clinician sonographer to appreciate the features consistent with Echinococcus cysts and distinguish from those features that are more consistent with other pathology. This case initially appears as a “classic” finding of Echinococcus disease. Ultimately, surgical pathology revealed a choledochal cyst, a rare finding in adulthood. However, when POCUS was performed, the findings were not consistent with hydatid disease. Initially given the region of her origin, the working diagnosis was an Echinococcus cyst. We present a case of a 27-year-old woman presenting to an emergency department in Peru with jaundice and abdominal pain. Point-of-care ultrasound can be helpful in performing the rapid diagnosis and therefore direct appropriate treatment strategies based on the results. However, even in the “classic” clinical scenario and setting, the clinician must maintain a broad differential diagnosis. Ultrasonography has been the gold standard for the diagnosis and staging of Echinococcus disease. In these practice settings, POCUS can have a significant impact on management strategies and patient care. It can rapidly diagnose both tropical infectious diseases and more common pathology at the bedside. The use of point-of-care ultrasound (POCUS) has become increasingly important in resource-limited settings.
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