What is the FASH Exam?

• Focused Assessment with Sonography for HIV/TB
• 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

1. 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
2. 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.