Goal-directed ultrasound in a limited resource healthcare setting and developing country
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CASE REPORT
Goal-directed ultrasound in a limited resource healthcare setting and developing country Fabrizio Elia • Tommaso Campagnaro Paola Salacone • Sara Casalis
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Received: 14 January 2010 / Accepted: 3 February 2011 / Published online: 19 February 2011 Ó Springer-Verlag 2011
Abstract Background In developing countries, access to diagnostic technology is limited by economic, social and geographical barriers. Diagnostic tools must be sustainable, effective and low cost. Case A 30-year-old man was admitted in a rural hospital with fever and chest pain and managed successfully with a goal-directed sonographic approach. Conclusion Ultrasound is a point of care, rapid, noninvasive and low-cost technology. Primary goal-directed ultrasound can be a high-impact diagnostic tool in scarce resource scenarios.
Introduction In developing countries access to diagnostic technology is limited by economic, social and geographical barriers. One of the aims of primary health care is introduce acceptable, achievable, sustainable and effective diagnostic tools in remote settings [1]. Ultrasound is a point of care, rapid, non-invasive and low-cost technology. Goal-directed ultrasound performed by non-radiologist physicians is focused on clinical problems and not limited to single anatomical areas. For these reasons, primary goal-directed ultrasound may be a highimpact diagnostic tool in scarce resource scenarios [2].
Keywords Developing country Diagnostic equipment Ultrasound Case report
F. Elia (&) Medicina d’Urgenza, Ospedale San Giovanni Bosco, Piazza Donatore del Sangue 3, 10154 Torino, Italy e-mail: [email protected] T. Campagnaro Dipartimento di Scienze, Anestesiologiche e Chirurgiche, Chirurgia Generale A, Policlinico ‘‘GB Rossi’’, P. le L.A. Scuro 10, 37134 Verona, Italy e-mail: [email protected] P. Salacone Gastroenterologia, Ospedale Mauriziano Umberto I, Largo Turati 62, 10128 Torino, Italy e-mail: [email protected] S. Casalis Medicina Generale, Ospedale Santo Spirito, Via Vittorio Emanuele 3, 12042 Bra, Italy e-mail: [email protected]
A 30-year-old man was admitted to a rural hospital in North Burundi (East Africa) with fever and chest pain. The patient had a history of several malarial attacks and arrived from an area with difficult access to safe water. Before 2 weeks of admission, he started to complain of fever and right sided pleuritic chest pain in absence of cough and dyspnea. He denied chills, night sweats, arthralgias or previous history of tuberculosis. Family history was unremarkable. Before 5 days of admission, he was evaluated at another health center. Pneumonia was suspected and amoxicillin was administered without clinical improvement. On admission, he was febrile and tachycardic. Other vital signs were normal. Physical examination revealed decreased breath sounds at right basal pulmonary field. Abdomen was tender in the right upper quadrant with negative Murphy’s and Blumberg’s signs. Chest x-ray was performed and revealed right-sided diaphragmatic
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