Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study

Rania Salah El Zayat; Wael Abbass Bahbah; Waleed Abd Elfattah Mousa

doi:doi:10.11648/j.ajp.20180401.14

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Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study

Rania Salah El Zayat, Wael Abbass Bahbah, Waleed Abd Elfattah Mousa

Published in American Journal of Pediatrics (Volume 4, Issue 1)

Received: 24 February 2018 Accepted: 21 March 2018 Published: 14 April 2018

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Abstract

Pneumonia is a major cause of morbidity and mortality in children especially in developing countaries. Lung ultrasonography (LUS) is an accepted safe diagnostic tool with many advantages over chest x-ray (CXR). The objective of this prospective observational study was to evaluate the usefulness of LUS in comparison with CXR for diagnosing pneumonia in 60 children presented with fever and respiratory distress. For each patient complete diagnostic workup was performed including history, physical examination, routine laboratory investigations, CXR and LUS. LUS was performed by a sonographer blinded to patient’s clinical and CXR findings. The patients were classified into; Pneumonia group: included 45 patients diagnosed by two clinicians as having community acquired pneumonia (CAP) based on the recommendations of British Thoracic Society and Non pneumonia group: included 15 patients received other diagnoses. The clinicians were blinded to CXR and LUS findings. In pneumonia group, sonographic and radiographic findings compatible with pneumonia were found in 95.6% and 88.9% of patients respectively. In non pneumonia group, LUS can exclude pneumonia in 93.3% of patients while CXR excluded pneumonia in 86.7% of them. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LUS to demonstrate lung involvement were higher than those of CXR (95.6%, 93.3%, 97.7%, 85.7% and 94.5% versus 88.9%, 86.7%, 95.2%, 72.2% and 86.7% respectively). LUS was superior to CXR in identifying pleural effusion and multiple consolidation in more than one lobe. Being safer, cheaper and relatively more time saving, lung ultrasonography offers an important contribution to the diagnosis of CAP in febrile children with respiratory distress compared to chest X-ray.

Published in	American Journal of Pediatrics (Volume 4, Issue 1)
DOI	10.11648/j.ajp.20180401.14
Page(s)	15-20
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Lung Ultrasonography, Chest X-ray, Pneumonia, Community Acquired Pneumonia, Respiratory Distress

References

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APA Style

Rania Salah El Zayat, Wael Abbass Bahbah, Waleed Abd Elfattah Mousa. (2018). Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study. American Journal of Pediatrics, 4(1), 15-20. https://doi.org/10.11648/j.ajp.20180401.14

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ACS Style

Rania Salah El Zayat; Wael Abbass Bahbah; Waleed Abd Elfattah Mousa. Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study. Am. J. Pediatr. 2018, 4(1), 15-20. doi: 10.11648/j.ajp.20180401.14

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AMA Style

Rania Salah El Zayat, Wael Abbass Bahbah, Waleed Abd Elfattah Mousa. Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study. Am J Pediatr. 2018;4(1):15-20. doi: 10.11648/j.ajp.20180401.14

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@article{10.11648/j.ajp.20180401.14,
  author = {Rania Salah El Zayat and Wael Abbass Bahbah and Waleed Abd Elfattah Mousa},
  title = {Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study},
  journal = {American Journal of Pediatrics},
  volume = {4},
  number = {1},
  pages = {15-20},
  doi = {10.11648/j.ajp.20180401.14},
  url = {https://doi.org/10.11648/j.ajp.20180401.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20180401.14},
  abstract = {Pneumonia is a major cause of morbidity and mortality in children especially in developing countaries. Lung ultrasonography (LUS) is an accepted safe diagnostic tool with many advantages over chest x-ray (CXR). The objective of this prospective observational study was to evaluate the usefulness of LUS in comparison with CXR for diagnosing pneumonia in 60 children presented with fever and respiratory distress. For each patient complete diagnostic workup was performed including history, physical examination, routine laboratory investigations, CXR and LUS. LUS was performed by a sonographer blinded to patient’s clinical and CXR findings. The patients were classified into; Pneumonia group: included 45 patients diagnosed by two clinicians as having community acquired pneumonia (CAP) based on the recommendations of British Thoracic Society and Non pneumonia group: included 15 patients received other diagnoses. The clinicians were blinded to CXR and LUS findings. In pneumonia group, sonographic and radiographic findings compatible with pneumonia were found in 95.6% and 88.9% of patients respectively. In non pneumonia group, LUS can exclude pneumonia in 93.3% of patients while CXR excluded pneumonia in 86.7% of them. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LUS to demonstrate lung involvement were higher than those of CXR (95.6%, 93.3%, 97.7%, 85.7% and 94.5% versus 88.9%, 86.7%, 95.2%, 72.2% and 86.7% respectively). LUS was superior to CXR in identifying pleural effusion and multiple consolidation in more than one lobe. Being safer, cheaper and relatively more time saving, lung ultrasonography offers an important contribution to the diagnosis of CAP in febrile children with respiratory distress compared to chest X-ray.},
 year = {2018}
}

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TY  - JOUR
T1  - Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study
AU  - Rania Salah El Zayat
AU  - Wael Abbass Bahbah
AU  - Waleed Abd Elfattah Mousa
Y1  - 2018/04/14
PY  - 2018
N1  - https://doi.org/10.11648/j.ajp.20180401.14
DO  - 10.11648/j.ajp.20180401.14
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 15
EP  - 20
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20180401.14
AB  - Pneumonia is a major cause of morbidity and mortality in children especially in developing countaries. Lung ultrasonography (LUS) is an accepted safe diagnostic tool with many advantages over chest x-ray (CXR). The objective of this prospective observational study was to evaluate the usefulness of LUS in comparison with CXR for diagnosing pneumonia in 60 children presented with fever and respiratory distress. For each patient complete diagnostic workup was performed including history, physical examination, routine laboratory investigations, CXR and LUS. LUS was performed by a sonographer blinded to patient’s clinical and CXR findings. The patients were classified into; Pneumonia group: included 45 patients diagnosed by two clinicians as having community acquired pneumonia (CAP) based on the recommendations of British Thoracic Society and Non pneumonia group: included 15 patients received other diagnoses. The clinicians were blinded to CXR and LUS findings. In pneumonia group, sonographic and radiographic findings compatible with pneumonia were found in 95.6% and 88.9% of patients respectively. In non pneumonia group, LUS can exclude pneumonia in 93.3% of patients while CXR excluded pneumonia in 86.7% of them. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LUS to demonstrate lung involvement were higher than those of CXR (95.6%, 93.3%, 97.7%, 85.7% and 94.5% versus 88.9%, 86.7%, 95.2%, 72.2% and 86.7% respectively). LUS was superior to CXR in identifying pleural effusion and multiple consolidation in more than one lobe. Being safer, cheaper and relatively more time saving, lung ultrasonography offers an important contribution to the diagnosis of CAP in febrile children with respiratory distress compared to chest X-ray.
VL  - 4
IS  - 1
ER  -

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Author Information

Rania Salah El Zayat

Department of Pediatrics, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Wael Abbass Bahbah

Department of Pediatrics, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Waleed Abd Elfattah Mousa

Department of Radiodiagnosis, Faculty of Medicine, Menoufia University, Menoufia, Egypt

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APA Style

Rania Salah El Zayat, Wael Abbass Bahbah, Waleed Abd Elfattah Mousa. (2018). Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study. American Journal of Pediatrics, 4(1), 15-20. https://doi.org/10.11648/j.ajp.20180401.14

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ACS Style

Rania Salah El Zayat; Wael Abbass Bahbah; Waleed Abd Elfattah Mousa. Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study. Am. J. Pediatr. 2018, 4(1), 15-20. doi: 10.11648/j.ajp.20180401.14

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AMA Style

Rania Salah El Zayat, Wael Abbass Bahbah, Waleed Abd Elfattah Mousa. Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study. Am J Pediatr. 2018;4(1):15-20. doi: 10.11648/j.ajp.20180401.14

Copy | Download

@article{10.11648/j.ajp.20180401.14,
  author = {Rania Salah El Zayat and Wael Abbass Bahbah and Waleed Abd Elfattah Mousa},
  title = {Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study},
  journal = {American Journal of Pediatrics},
  volume = {4},
  number = {1},
  pages = {15-20},
  doi = {10.11648/j.ajp.20180401.14},
  url = {https://doi.org/10.11648/j.ajp.20180401.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20180401.14},
  abstract = {Pneumonia is a major cause of morbidity and mortality in children especially in developing countaries. Lung ultrasonography (LUS) is an accepted safe diagnostic tool with many advantages over chest x-ray (CXR). The objective of this prospective observational study was to evaluate the usefulness of LUS in comparison with CXR for diagnosing pneumonia in 60 children presented with fever and respiratory distress. For each patient complete diagnostic workup was performed including history, physical examination, routine laboratory investigations, CXR and LUS. LUS was performed by a sonographer blinded to patient’s clinical and CXR findings. The patients were classified into; Pneumonia group: included 45 patients diagnosed by two clinicians as having community acquired pneumonia (CAP) based on the recommendations of British Thoracic Society and Non pneumonia group: included 15 patients received other diagnoses. The clinicians were blinded to CXR and LUS findings. In pneumonia group, sonographic and radiographic findings compatible with pneumonia were found in 95.6% and 88.9% of patients respectively. In non pneumonia group, LUS can exclude pneumonia in 93.3% of patients while CXR excluded pneumonia in 86.7% of them. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LUS to demonstrate lung involvement were higher than those of CXR (95.6%, 93.3%, 97.7%, 85.7% and 94.5% versus 88.9%, 86.7%, 95.2%, 72.2% and 86.7% respectively). LUS was superior to CXR in identifying pleural effusion and multiple consolidation in more than one lobe. Being safer, cheaper and relatively more time saving, lung ultrasonography offers an important contribution to the diagnosis of CAP in febrile children with respiratory distress compared to chest X-ray.},
 year = {2018}
}

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TY  - JOUR
T1  - Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study
AU  - Rania Salah El Zayat
AU  - Wael Abbass Bahbah
AU  - Waleed Abd Elfattah Mousa
Y1  - 2018/04/14
PY  - 2018
N1  - https://doi.org/10.11648/j.ajp.20180401.14
DO  - 10.11648/j.ajp.20180401.14
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 15
EP  - 20
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20180401.14
AB  - Pneumonia is a major cause of morbidity and mortality in children especially in developing countaries. Lung ultrasonography (LUS) is an accepted safe diagnostic tool with many advantages over chest x-ray (CXR). The objective of this prospective observational study was to evaluate the usefulness of LUS in comparison with CXR for diagnosing pneumonia in 60 children presented with fever and respiratory distress. For each patient complete diagnostic workup was performed including history, physical examination, routine laboratory investigations, CXR and LUS. LUS was performed by a sonographer blinded to patient’s clinical and CXR findings. The patients were classified into; Pneumonia group: included 45 patients diagnosed by two clinicians as having community acquired pneumonia (CAP) based on the recommendations of British Thoracic Society and Non pneumonia group: included 15 patients received other diagnoses. The clinicians were blinded to CXR and LUS findings. In pneumonia group, sonographic and radiographic findings compatible with pneumonia were found in 95.6% and 88.9% of patients respectively. In non pneumonia group, LUS can exclude pneumonia in 93.3% of patients while CXR excluded pneumonia in 86.7% of them. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LUS to demonstrate lung involvement were higher than those of CXR (95.6%, 93.3%, 97.7%, 85.7% and 94.5% versus 88.9%, 86.7%, 95.2%, 72.2% and 86.7% respectively). LUS was superior to CXR in identifying pleural effusion and multiple consolidation in more than one lobe. Being safer, cheaper and relatively more time saving, lung ultrasonography offers an important contribution to the diagnosis of CAP in febrile children with respiratory distress compared to chest X-ray.
VL  - 4
IS  - 1
ER  -

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