Lung Ultrasonography Beyond the Diagnosis of Pediatrics Pneumonia

Abstract

Pneumonia is a prevalent disease with considerable morbidity and mortality among the pediatric population. Early diagnosis and swift commencement of the correct treatment are vital for a favorable clinical outcome. Along with history-taking and clinical examination, imaging modalities commonly used, lung ultrasound provides a bedside, less invasive, radiation-free alternative to diagnose pneumonia when compared with other images such as chest x-ray (CXR) and computed tomography (CT) scan. It is therefore of the utmost magnitude to inspect the evidence of its accuracy and reliability in the diagnosis of this condition. The goal of this study is to look into the available data supporting the use of lung ultrasound in the diagnosis of juvenile pneumonia, its relevance in distinguishing between viral and bacterial diseases, and its superiority as compared to other diagnostic methods. As mentioned, early detection and differentiation of the type of pneumonia can reduce unnecessary antibiotic prescriptions and provide patients with a better prognosis, as well as the ability to predict the course of the disease and the need for advanced care or the development of complications. An extensive literature search of two popular online medical websites (PubMed and Embase) was conducted in this review, concentrating on studies that examined the role of lung ultrasound in the diagnosis of pediatric pneumonia published in the last five years. Only studies published in the English language were included in this review. With high sensitivity and specificity, lung ultrasound appeared to be a promising tool not only for pediatric pneumonia diagnosis, but also for treatment guidance and disease follow-up, especially when combined with clinical presentation and laboratory findings.

Lung Ultrasound and Neutrophil Lymphocyte Ratio in Early Diagnosis and Differentiation between Viral and Bacterial Pneumonia in Young Children

“…Radiographic failures are primarily related to the size of the pneumonic patch (<1 cm) and its posterior location. Ho et al reported that CXR showed no obvious lesions in 12 (7.4%) patients [ 10 ], and Iorio et al also reported that 4 (7.6%) had negative CXR findings [ 27 ]. Lung consolidation of less than 1 cm has been reported to be undetectable by CXR [ 28 ].…”

“…Lung consolidation of less than 1 cm has been reported to be undetectable by CXR [ 28 ]. They explained the failure of CXR in lesion detection due to (1) the small size and radiolucency in the early stages of the pneumonic process, (2) the posterior position of the lesion beyond the heart or mediastinum, and (3) the alveolar pattern of the pneumonic patch [ 10 , 27 , 28 ].…”

“…Lung ultrasound (LUS) has emerged as a very important non-ionizing radiation diagnostic tool in the detection of lung and pleural diseases in pediatrics [ 5 , 6 , 7 , 8 , 9 , 10 ]. LUS has shown high diagnostic accuracy compared to CXR and computed tomography (CT) in the diagnosis and follow-up of community-acquired pneumonia (CAP) in pediatrics [ 11 , 12 ].…”

Editorial: Application of lung ultrasound in the management of pediatric lung diseases

“…The World Health Organization ( 5 ) reported that pneumonia killed 740,180 children in 2019, accounting for 14% of all deaths of children under five. For the diagnosis of pediatric pneumonia, LUS has a sensitivity (95.0%) and specificity (96.1%) ( 6 ) higher than a chest x-ray and is now considered as one of the preferable first-line modality tests ( 7 ).…”