ULTRASOUND-DETECTED HEPATIC PERIPORTAL THICKENING IN PATIENTS WITH PROLONGED PYREXIA

Hepatic periportal thickening (HPT) detected by ultrasonography has be en established as a reliable tool for measuring hepatic morbidity due to schistosomiasis. During ultrasonographic examination of patients wi th prolonged pyrexia, we frequently noticed minimal grades of HPT in p atients without a history of schistosomiasis. This led to ultrasonogra phic studies of conditions other than schistosomiasis in which HPT may occur. Subjects included 460 patients with Schistosoma haematobium in fection, 107 urban patients with prolonged pyrexia without previous ex posure to schistosomiasis, and 288 healthy controls unexposed to schis tosomiasis. Grade I HPT was more prevalent (P < 0.001) in patients wit h pyrexia (56.1%) than in those with S. haematobium (32.2%) and was mo re frequent (P < 0.001) in patients with S. haematobium than in contro ls (11.1%). Typhoid fever was the most common febrile illness causing HPT. Grade II lesions were rare in patients with:pyrexia (2.8%) or sch istosomiasis (0.9%). Grade III lesions were present in only one patien t with S. haematobium. Mild grades of HPT can occur in infectious dise ases other than schistosomiasis. Cellular infiltration in the portal t ract from chronic infectious diseases can frequently give the ultrason ographic appearance of grade I HPT.