title: Lung ultrasound characteristics of community-acquired pneumonia in hospitalized children.
abstract: BACKGROUND
  The diagnosis of community-acquired pneumonia (CAP) is based mainly on the patient's medical history and physical examination. However, in severe cases a further evaluation including chest X-ray (CXR) may be necessary. At present, lung ultrasound (LUS) is not included in the diagnostic work-up of pneumonia.
  
  
  OBJECTIVE
  To describe the ultrasonographic appearance of CAP at presentation and during the follow-up.
  
  
  METHODS
  A total of 102 patients with clinical signs and symptoms suggesting pneumonia, who underwent a clinically driven CXR, were evaluated by LUS on the same day. LUS signs of pneumonia included subpleural lung consolidation, B-lines, pleural line abnormalities, and pleural effusion. The diagnostic gold standard was the ex-post diagnosis of pneumonia made by two independent experienced pediatricians on the basis of clinical presentation, CXR and clinical course following British Thoracic Guidelines recommendations.
  
  
  RESULTS
  A final diagnosis of pneumonia was confirmed in 89/102 patients. LUS was positive for the diagnosis of pneumonia in 88/89 patients, whereas CXR was positive in 81/89. Only one patient with normal LUS examination had an abnormal CXR, whereas 8 patients with normal CXR had an abnormal LUS. LUS was able to detect pleural effusion resulting from complicated pneumonia in 16 cases, whereas CXR detected pleural effusion in 3 cases.
  
  
  CONCLUSIONS
  LUS is a simple and reliable imaging tool, not inferior to CXR in identifying pleuro-pulmonary alterations in children with suspected pneumonia. During the course of the disease, LUS allows a radiation-free follow-up of these abnormalities.
authors.affiliation: Department of Pediatrics, Perrino Hospital, Brindisi, Italy. antoniocaiulo@inwind.it
authors.forename: Vito Antonio
authors.initials: VA
authors.lastname: Caiulo
authors.forename: Luna
authors.initials: L
authors.lastname: Gargani
authors.forename: Silvana
authors.initials: S
authors.lastname: Caiulo
authors.forename: Andrea
authors.initials: A
authors.lastname: Fisicaro
authors.forename: Fulvio
authors.initials: F
authors.lastname: Moramarco
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Latini
authors.forename: Eugenio
authors.initials: E
authors.lastname: Picano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mele
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology; D011014:Pneumonia / Q000150:complications / Q000000981:diagnostic imaging*; D011859:Radiography; D016037:Single-Blind Method; D014463:Ultrasonography