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Pediatr Pulmonol. 2019 Jul 1. doi: 10.1002/ppul.24426. [Epub ahead of print]

Lung ultrasound features of children with complicated and noncomplicated community acquired pneumonia: A prospective study.

Author information

1
Department of Pediatric Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
2
Department of Radiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
3
Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.

Abstract

OBJECTIVE:

The purpose of this study was to describe lung ultrasound (LUS) findings at baseline and 48 hours after the beginning of treatment and evaluate how they correlate with outcome DESIGN: We prospectively analyzed patients from 1 month to 17 years of age with community acquired pneumonia (CAP) evaluated at a tertiary level pediatric hospital. At baseline and 48 hours after the beginning of treatment, history, clinical examination, laboratory testing, chest X-ray, and LUS were performed.

RESULTS:

One hundred one children were enrolled in the study (13 with complicated CAP). At baseline those who developed complications presented a larger size of the subpleural pulmonary parenchymal lesions (P = .001) often associated with a complex pleural effusion (63.6%, P = .013). Those with an uncomplicated CAP presented an air, arboriform, superficial and dynamic bronchogram, as opposed to complicated CAP which had an air and liquid bronchogram, deep, fixed (P = .001). At the 48-hour control in the noncomplicated CAP group, bronchogram was more frequently superficial and dynamic (P = .050). Pleural effusion disappeared in half cases (P = .050). In all patients, neutrophilic leucocytosis with increased C-reactive protein was detected and decreased at control (P = .001). The linear regression analyses showed the switch from a deep to a superficial bronchogram as the only explanatory variable (r = 0.97, R2  = 0.94, P = .001, t = 10.73).

CONCLUSIONS:

Our study describe early LUS features of CAP that might be able to predict the development of complicated CAP.

KEYWORDS:

TB; imaging; infections: pneumonia; viral

PMID:
31264383
DOI:
10.1002/ppul.24426

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