A Study of Lung Ultrasonography in Childhood Pneumonia as a Quick and Safe Alternative Tool in a Group of Egyptian Children
Hoda Reda Abd El Azeim Al Nidany;
Abstract
SUMMARY
P
neumonia remains the leading infectious cause of death among children under five, killing 2,500 children a day. Early intervention and prompt treatment of acute respiratory infection and pneumonia are the easiest way to prevent death.
Despite a long-held belief that physical examination findings and proper auscultation are sufficient to rule in or out the presence of pneumonia, multiple pressures in clinical practice have driven increased use of chest radiography and occasionally CT. During the last 10 years, ultrasound has been shown to be highly effective in evaluating a range of pathologic pulmonary conditions. The most widely studied and practiced applications are the evaluation of pneumonia and pleural effusion with ultrasound.
The present cross sectional study was designed to assess lung ultrasonography as a diagnostic tool in diagnosis of children with Pneumonia attended Paediatric Emergency Department, Children's hospital, Ain Shams university hospitals, during the period between October 2015 and march 2016, compared to the diagnosis with chest X rays.
This study included 60 children presenting with fever and respiratory distress. Forty five patients clinically diagnosed with pneumonia, their ages ranged from 12 months to 5 years with mean age 24.11 ± 9.42 (SD) months. Males were 64.4 % while females were 35.6% with male to female ratio 1.8:1. Fifteen patients were collected according to inclusion criteria but not diagnosed clinically as pneumonic patients (non pneumonia group), they were in age and sex matching with the pneumonia cases.
The studied cases were subjected to full history taking, full clinical examination, blood sample analysis, radiological evaluation with chest X rays, chest ultrasonography.
Results of the current study showed that in comparison to chest X-ray for diagnosis of pneumonia cases:
Chest US detected sonographic findings in 43 patients of 45 children with pneumonia as following consolidation was detected in 43/45 (95.6%), Air bronchograme in 39/45 (86.7%), multiple B-lines in 22/45 (48.9%), pleural effusion in 11/45 (24.4%) and pleural line abnormalities was detected in 8/45 (17.8%). Finally LUS showed sensitivity 95.6%, specificity 93.3%, positive predictive value 97.7% and diagnostic accuracy 94.4% in diagnosing of total cases with pneumonia. While chest x-ray detected radiographic findings in 40 patients of 45 children of clinical pneumonia. Consolidation was found in 40/45 (88.9%) and pleural effusion was found in 7/45 (15.6%) with sensitivity 88.9%, specificity 86.7%, positive predictive value 95.2% and diagnostic accuracy 86.7%.
P
neumonia remains the leading infectious cause of death among children under five, killing 2,500 children a day. Early intervention and prompt treatment of acute respiratory infection and pneumonia are the easiest way to prevent death.
Despite a long-held belief that physical examination findings and proper auscultation are sufficient to rule in or out the presence of pneumonia, multiple pressures in clinical practice have driven increased use of chest radiography and occasionally CT. During the last 10 years, ultrasound has been shown to be highly effective in evaluating a range of pathologic pulmonary conditions. The most widely studied and practiced applications are the evaluation of pneumonia and pleural effusion with ultrasound.
The present cross sectional study was designed to assess lung ultrasonography as a diagnostic tool in diagnosis of children with Pneumonia attended Paediatric Emergency Department, Children's hospital, Ain Shams university hospitals, during the period between October 2015 and march 2016, compared to the diagnosis with chest X rays.
This study included 60 children presenting with fever and respiratory distress. Forty five patients clinically diagnosed with pneumonia, their ages ranged from 12 months to 5 years with mean age 24.11 ± 9.42 (SD) months. Males were 64.4 % while females were 35.6% with male to female ratio 1.8:1. Fifteen patients were collected according to inclusion criteria but not diagnosed clinically as pneumonic patients (non pneumonia group), they were in age and sex matching with the pneumonia cases.
The studied cases were subjected to full history taking, full clinical examination, blood sample analysis, radiological evaluation with chest X rays, chest ultrasonography.
Results of the current study showed that in comparison to chest X-ray for diagnosis of pneumonia cases:
Chest US detected sonographic findings in 43 patients of 45 children with pneumonia as following consolidation was detected in 43/45 (95.6%), Air bronchograme in 39/45 (86.7%), multiple B-lines in 22/45 (48.9%), pleural effusion in 11/45 (24.4%) and pleural line abnormalities was detected in 8/45 (17.8%). Finally LUS showed sensitivity 95.6%, specificity 93.3%, positive predictive value 97.7% and diagnostic accuracy 94.4% in diagnosing of total cases with pneumonia. While chest x-ray detected radiographic findings in 40 patients of 45 children of clinical pneumonia. Consolidation was found in 40/45 (88.9%) and pleural effusion was found in 7/45 (15.6%) with sensitivity 88.9%, specificity 86.7%, positive predictive value 95.2% and diagnostic accuracy 86.7%.
Other data
| Title | A Study of Lung Ultrasonography in Childhood Pneumonia as a Quick and Safe Alternative Tool in a Group of Egyptian Children | Other Titles | دراسة الموجات فوق الصوتية على الرئة كبديل آمن وسريع في تشخيص مرض الالتهاب الرئوي في مجموعة من الأطفال المصريين | Authors | Hoda Reda Abd El Azeim Al Nidany | Issue Date | 2016 |
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