Recent advances in the ultrasound technology especially with the advent of very high-resolution machines, it is now possible to image several parasites which infest human body. Ultrasound can also be used to detect complications. This talk focuses on various parasites, which can be studied on ultrasound -- highlighting their lifecycles, complications and its role in follow up.

One of the most common helminth to infest human body is Ascaris lumbricoides, commonly seen in the biliary system and the intestines. Patients can present with biliary colic or jaundice. Ascaris in the intestine may be seen on ultrasound even in asymptomatic patients. However, we have seen complications like intestinal obstruction, bowel inflammation, intussusception and even bowel perforation.
Other intestinal parasites seen on ultrasound are Enterobius vermicularis and Trichuris trichiura. These are seen in the region of caecum and appendix. Echinococcus granulosa commonly affects the liver and has characteristic features on ultrasound like hydatid fluid, hydatid sand and daughter cyst. Various classifications of hydatid disease of liver are discussed in the talk. We have used scolicidal agents under ultrasound guidance and followed up patients. Some of the patients have been subjected to laparoscopic resection. We have also seen hydatid at other places like renal, lower abdomen, lung, spleen and even abdominal wall.

Amongst the protozoal infection Entamoeba hystolitica is most common, presenting to the sonologist as a liver abscess. Various stages of liver abscess, complications and management are discussed.

The other parasite, which is very well seen on ultrasound because of its real time capability, is Wuchiraria bancrofti or filariasis. Filarial dance is commonly seen in the inguino-scrotal region, epididymis, retroperitonium and breast. We can also follow up patients after therapy. Though ultrasound has a limited role to play in the evaluation of Plasmodium vivax & P.falsiparum, it plays a major role in diagnosing their complications and differentiating malaria from dengue, which is a viral infection, but with similar presentation.

Bilharziasis or Schistosomiasis has classical ultrasound features like bladder wall thickening, calcifications, peri-portal fibrosis, and portal hypertension.
Cysticercosis has been seen to infect all muscles including orbital muscles with classical diagnostic features on ultrasound.

Similarly, Dracunculus medinensis has classical ultrasound features.
Other protozoal infestations, which have ultrasound features, include Toxoplasma gondii in antenatal life.

The talk covers entire spectrum of ultrasound manifestations of parasitic infestations in human body. Parasitic infestation is very common in a large number of countries. Ultrasound being relatively a cheap modality can play a major role in evaluating parasites especially in developing and third world countries