Abstract
Background
Pneumonia is one of the most common diseases with a high hospitalization rate and is potentially life threatening. Chest ultrasound (US) is increasingly being used as a valuable bedside tool in the diagnosis of various thoracic conditions, especially pneumonia.
Patients and methods
A total of 120 patients clinically suspected as having pneumonia were selected. Chest US was performed for the number, location, shape, size, breathdependent movement of pneumonia, incidence of necrotic areas, positive air bronchogram, fluid bronchogram, and pleural effusion either simple or septated. Follow-up was carried out on days 1, 5, 8, and 14.
Results
Patients? ages ranged from 24 to 85 (58.5±15.2) years. Of them, 73 (60.8%) were male and 47 (39.2%) were female. Chest US showed positive findings in 116 (96.7%) patients, with a sensitivity of 97.4%, specificity of 25%, and accuracy of 95%. There was a highly significant difference (P <0.001) between chest US and plain chest radiography in detecting pneumonia, whereas there was no significant difference (P>0.5) between chest US and chest computed tomography. Chest US had a high significant difference (P <0.001) in detecting minimal pleural effusion over plain radiography. Moreover, it had a sensitivity of 93.8%, specificity of 99%, and accuracy of 98.3% in detecting complex septated pleural effusion. Improvement in pneumonia was detected in 111 patients (95.7%) with chest US, whereas improvement was detected in 76 (75.2%) patients with plain chest radiography after 14 days; this was highly significant (P <0.001).
Conclusion
Chest US is a quick, bedside, noninvasive, nonionizing, and highly sensitive tool to detect and follow-up cases of pneumonia and parapneumonic effusion.
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Mayaud C. Pneumonia is the leading cause of death of infectious origin. Rev Prat 2011; 61:1061–1063.
Restrepo MI, Faverio P, Anzueto A. Long-term prognosis in communityacquired pneumonia. Curr Opin Infect Dis 2013; 26:151–158.
Parlamento S, Copetti R, Di Bartolomeo S. Evaluation of lung ultrasound for the diagnosis of pneumonia in the ED. Am J Emerg Med 2009; 27:379–384.
Reissig A, Copetti R, Mathis G, Mempel C, Schuler A, Zechner P, et al. Lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia: a prospective, multicenter, diagnostic accuracy study. Chest 2012; 142:965–972.
Syrjälä H, Broas M, Suramo I, Ojala A, Lähde S. High-resolution computed tomography for the diagnosis of community-acquired pneumonia. Clin Infect Dis 1998; 27:358–363.
Esayag Y, Nikitin I, Bar-Ziv J, Cytter R, Hadas-Halpern I, Zalut T, et al. Diagnostic value of chest radiographs in bedridden patients suspected of having pneumonia. Am J Med 2010; 123:88.e1e5.
Zhang M, Liu ZH, Yang JX, Gan JX, Xu SW, You XD, et al. Rapid detection of pneumothorax by ultrasonography in patients with multiple trauma. Crit Care 2006; 10:R112.
Middleton WD, Kurtz AB, Hertzberg BS. Ultrasound, the requisites [chapter 1]. 2nd ed. Boston: Mosby; 2004.
Garmer M, Hennigs SP, Jäger HJ, Schrick F, van de Loo T, Jacobs A, et al. Digital radiography versus conventional radiography in chest imaging: diagnostic performance of a large-area silicon flat-panel detector in a clinical CT-controlled study. Am J Roentgenol 2000; 174:75–80.
Woodhead M, Blasi F, Ewig S, Garau J, Huchon G, Ieven M, et al. Guidelines for the management of adult lower respiratory tract infections. Clin Microbiol Infect 2011; 17:E1– E59.
Fishman JA. Approach to acute bronchitis and community acquired pneumonia [chapter 128]. In: Kotllof RM, Elias JA, Fishman JA, Grippi MA, Senior RM, Pack A. Fishman’s pulmonary diseases and disorders. 5th ed. United States of America: The McGraw-Hill Companies, Inc.; 2015. p 2265.
Angelika R, Andrea G, Stefano A. Role of lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia. Eur J Intern Med 2012; 23:391–397.
Cortellaro F, Colombo S, Coen D, Duca PG. Lung ultrasound is an accurate diagnostic tool for the diagnosis of pneumonia in the emergency department. Emerg Med J 2012; 29:19–23.
Blaivas M. Lung ultrasound in evaluation of pneumonia. J Ultrasound Med 2012; 31:823–826.
Koh DM, Burke S, Davies N, Padley SP. Transthoracic US of the chest: clinical uses and applications. Radiographics 2002; 22:e1.
Lichtenstein DA, Mezie’re GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest 2008; 134:117–125.
Kim OH, Kim WS, Kim MJ, Jung JY, Suh JH. US in the diagnosis of pediatric chest diseases. Radiographics 2000; 20:653–671.
Lichtenstein DA, Mezie’re GA, Seitz J. The dynamic air bronchogram. A lung ultrasound sign of alveolar consolidation ruling out atelectasis. Chest 2009; 135:1421e5.
Chen HJ, Yu YH, Tu CY, Chen CH, Hsia TC, Tsai KD, et al. Ultrasound in peripheral pulmonary air-fluid lesions: color Doppler imaging as an aid in differentiating empyema and abscess, Chest 2009; 135: 1426–1432.
Cortellaro F, Colombo S, Coen D, Duca PG. Lung ultrasound is an accurate diagnostic tool for the diagnosis of pneumonia in the emergency department. Emerg Med J 2012; 19:19–23.
Liu J, Liu F, Liu Y, Wang HW, Feng ZC. Lung ultrasonography for the diagnosis of severe neonatal pneumonia. Chest 2014; 146:383–388.
Caiulo VA, Gargani L, Caiulo S, Fisicaro A, Moramarco F, Latini G, et al. Lung ultrasound characteristics of community-acquired pneumonia in hospitalized children. Pediatr Pulmonol 2013; 48:280–287.
Agmy G, Ahmed Y. Role of transthoracic sonography in diagnosis and follow up of community acquired pneumonia in emergency department. Eur Respir J 2013; 42(Suppl 57):228.
Alkhayat KF, Alam Eldeen MS. Value of chest ultrasound in diagnosis of community acquired pneumonia. Egypt J Chest Dis Tuberc 2014; 63: 1047–1051.
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Moghawri, M.W., Mansour, W., Lakouz, K.A. et al. Role of chest ultrasonography in the diagnosis and follow-up of community-acquired pneumonia at Zagazig University Hospitals. Egypt J Bronchol 11, 29–35 (2017). https://doi.org/10.4103/1687-8426.198991
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DOI: https://doi.org/10.4103/1687-8426.198991