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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.

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



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.


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).


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


TB; imaging; infections: pneumonia; viral


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