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Interv Med Appl Sci. 2014 Mar;6(1):40-2. doi: 10.1556/IMAS.6.2014.1.6. Epub 2014 Mar 14.

A dynamic sign of alveolar consolidation in bedside ultrasonography: Air bronchogram.

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1
Emergency Department, İzmir Katip Çelebi University Atatürk Research and Training Hospital İzmir Turkey.

Abstract

Acute dyspnoea is one of the most common reasons patients present to the emergency department (ED). In most cases, the physical examination and bedside radiographs are inconclusive, resulting in the need for more sophisticated diagnostics. These diagnostics may delay treatment or expose the patient to unnecessary radiation. Here, we present the case of a dyspnoeic patient. The patient was diagnosed with pneumonia by bedside thoracic ultrasonography (TUS). TUS was performed by the emergency physician and revealed bilateral pleural effusion, which was more significant on the right side of the thorax. The right lower lung lobe was consolidated, and dynamic air bronchograms were present on TUS. Computerised tomography of the chest was ordered. Bilateral multilobar consolidations were clearly appreciated with bilateral pleural effusion. Because of the dynamic nature of the disease process, we were able to diagnose pathological changes in the lung. In conclusion, TUS may be used for diagnosing pneumonia in the ED because it has high accuracy, low cost and no radiation exposure. Furthermore, it can be used bedside, and there is no need to transport an emergent patient to the radiology unit.

KEYWORDS:

air bronchogram; bedside ultrasonography; emergency; pneumonia

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