title: Lung ultrasound in the diagnosis and monitoring of community acquired pneumonia in children.
abstract: Lung ultrasound (LUS) is as an easily accessible, radiation-free imaging technique that might be used as a diagnostic tool in community-acquired pneumonia (CAP). The aim of the study was to evaluate the usefulness and accuracy of LUS in the diagnosis and monitoring of childhood CAP. One hundred six consecutive children aged between 1 and 213 (median 52.5) months referred to the hospital with suspicion of CAP were enrolled. All patients underwent LUS on the day of admission, followed by chest radiograph (CXR). Lung ultrasound was also performed in 25 children between 5th-7th and 31 children between 10th-14th day after admission. Radiographic signs of pneumonia were demonstrated in 76 children, while lung ultrasound revealed pulmonary abnormalities consistent with pneumonia in 71 children. LUS gave false negative results in 5 patients with parahilar pulmonary infiltrates demonstrated by CXR. Almost perfect overall agreement between LUS and CXR was found in terms of pneumonia diagnosis (Cohen kappa coefficient of 0.89). The diagnostic performance of LUS in demonstration of lung involvement was as follows: sensitivity of 93.4%, specificity of 100%, positive predictive value of 100%, negative predictive value of 85.7% and accuracy of 95.3%. Our study showed that LUS is a sensitive and highly specific diagnostic method in children with CAP. Therefore, LUS may be considered as the first imaging test in children with suspicion of CAP. A diagnostic algorithm of CAP which includes LUS should be validated in prospective studies. Lung ultrasound can also be used to follow-up resolution of pneumonic lesions.
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Dzialdowska 1, 01-184 Warsaw, Poland. Electronic address: emilia.urbankowska@gmail.com.
authors.forename: Emilia
authors.initials: E
authors.lastname: Urbankowska
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Dzialdowska 1, 01-184 Warsaw, Poland. Electronic address: katarzynakrenke@gmail.com.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Krenke
authors.affiliation: Department of Pediatric Radiology, Medical University of Warsaw, Dzialdowska 1, 01-184 Warsaw, Poland. Electronic address: lukdrob@yahoo.com.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Drobczyński
authors.affiliation: Department of Internal Medicine, Pneumonology and Allergy, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland. Electronic address: drkorczynski@gmail.com.
authors.forename: Piotr
authors.initials: P
authors.lastname: Korczyński
authors.affiliation: Department of Internal Medicine, Pneumonology and Allergy, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland. Electronic address: tomasz.urbankowski@gmail.com.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Urbankowski
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Dzialdowska 1, 01-184 Warsaw, Poland. Electronic address: martkakrawiec@wp.pl.
authors.forename: Marta
authors.initials: M
authors.lastname: Krawiec
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Dzialdowska 1, 01-184 Warsaw, Poland. Electronic address: grazyna.kraj@gmial.com.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Kraj
authors.affiliation: Department of Pediatric Radiology, Medical University of Warsaw, Dzialdowska 1, 01-184 Warsaw, Poland. Electronic address: mbrzewski@me.com.
authors.forename: Michał
authors.initials: M
authors.lastname: Brzewski
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Dzialdowska 1, 01-184 Warsaw, Poland. Electronic address: marek.kulus@wum.edu.pl.
authors.forename: Marek
authors.initials: M
authors.lastname: Kulus
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000097:blood / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D009504:Neutrophils / Q000473:pathology; D011014:Pneumonia / Q000097:blood / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Chest radiography; Imaging techniques; Pediatrics; Pneumonia; Ultrasound