Hepatic Infection

Question 1

Fungal infection

Answer 1

Neutropenic patient
Wheel within wheel : biopsy from Central echogenic will reveal fungal pseudohyphae in candidiasis
Bulls eye
Uniformly hypoechoic: fibrosis
Echogenic: calcification or fibrosis

Question 2

Amoebic

Answer 2

No wall
Attached to diaphragm
Hypoechoic
Fine internal echoes
Migrate from colon
Most recovery from medical therapy

Question 3

Hydatid

Answer 3

Duodenum migrate to portal to liver
Also in lung, kidney, spleen, CNS and bone
Three layers:
Pericyst: host reaction thick connective tissue
Ectocyst: may calcify
Endocyst: inner germinal layer: protoscolices/ brood capsules: form hydatid sand
Appearances:
Simple cyst with sand
Cyst with detached and floating endocyst membrane
Solid cystic
Densely calcified
Surgery mostly
Aspiration: recurrence due to inadequate therapy/ viable parasites

Question 4

Schistosomiasis
Pneumocystis
Atypical myco

Answer 4

Schisto: presinusoidal portal hypertension due to fibrosis
Pneumocystis: fine echogenic throughout liver or densely calcified clumps like myco avium intracellullare

Had one Balaji case