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Can Lung Ultrasound Act as a Diagnosis and Monitoring Tool in Children with Community Acquired Pneumonia? Correlation
Raluca Isac1,2, Alexandra-Monica Cugerian-Ratiu2, Andrada-Mara Micsescu-Olah1,2
1Department of Pediatrics, IIIrd Pediatric Clinic, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Insights
Lung ultrasound (LUS) aids in diagnosing community-acquired pneumonia (CAP) in children when clinical signs are unclear. This sensitive, non-invasive tool can identify pneumonia even when it
Area of Science:
- Pediatric Pulmonology
- Medical Imaging
- Infectious Diseases
Background:
- Community-acquired pneumonia (CAP) is a major cause of child mortality in low- and middle-income countries.
- Diagnosis typically involves clinical evaluation, lab tests, and imaging.
- Lung ultrasound (LUS) offers a sensitive, non-invasive, and radiation-free method for lung assessment.
Purpose of the Study:
- To evaluate the diagnostic utility of LUS in pediatric CAP.
- To explore the correlation between LUS findings and CAP severity or sepsis risk.
- To emphasize the importance of LUS in diagnosing and monitoring pediatric CAP.
Main Methods:
- Analysis of 102 children (1 month to 18 years) admitted with CAP.
- Clinical assessment including symptoms like fever, cough, tachypnea, and respiratory distress.
- Diagnosis confirmed using LUS findings, even in cases of clinically or radiologically occult pneumonia.
Main Results:
- LUS successfully diagnosed CAP in 102 pediatric patients.
- Underweight was prevalent in younger children (44.11%), while overweight affected older children (11.36%).
- LUS identified pneumonia in cases where it was clinically (21.56%) or radiologically (5.88%) occult.
Conclusions:
- Detailed clinical examination and LUS are crucial for diagnosing pediatric CAP.
- LUS is a highly sensitive diagnostic tool for pneumonia in children.
- Integrating LUS into CAP diagnostic algorithms is recommended for future practice.
Abstract:
Background: Community-acquired pneumonia (CAP) is the leading cause of mortality in children from middle- to low-income countries; diagnosing CAP includes clinical evaluation, laboratory testing and pulmonary imaging. Lung ultrasound (LUS) is a sensitive, accessible, non-invasive, non-radiant method for accurately evaluating the lung involvement in acute diseases. Whether LUS findings can be correlated with CAP's severity or sepsis risk remains debatable. This study aimed to increase the importance of LUS in diagnosing and monitoring CAP. We analyzed 102 children aged 1 month up to 18 years, hospital admitted with CAP. Mean age was 5.71 ± 4.85 years. Underweight was encountered in 44.11% of children, especially below 5 years, while overweight was encountered in 11.36% of older children and adolescents. Patients with CAP presented with fever (79.41%), cough (97.05%), tachypnea (18.62%), respiratory failure symptoms (20.58%), chest pain (12.74%) or poor feeding. Despite the fact that 21.56% had clinically occult CAP and six patients (5.88%) experienced radiologically occult pneumonia, CAP diagnosis was established based on anomalies detected using LUS. Conclusions: Detailed clinical examination with abnormal/modified breath sounds and/or tachypnea is suggestive of acute pneumonia. LUS is a sensitive diagnostic tool. A future perspective of including LUS in the diagnosis algorithm of CAP should be taken into consideration.
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