Role of chest ultrasonography in the diagnosis and follow-up of community-acquired pneumonia at Zagazig University Hospitals

Mohammad Walaa Saied Moghawri, Waleed Mansour, Khaled Ahmad Lakouz, Rabieh Mohammad M Hussein

Egyptian Journal of Bronchology 2017 11(1):29-35

Background Pneumonia is one of the most common diseases with a high hospitalization rate and is potentially life threatening. Chest ultrasound (US) is increasingly being used as a valuable bedside tool in the diagnosis of various thoracic conditions, especially pneumonia. Patients and methods A total of 120 patients clinically suspected as having pneumonia were selected. Chest US was performed for the number, location, shape, size, breath-dependent movement of pneumonia, incidence of necrotic areas, positive air bronchogram, fluid bronchogram, and pleural effusion either simple or septated. Follow-up was carried out on days 1, 5, 8, and 14. Results Patientsʼ ages ranged from 24 to 85 (58.5±15.2) years. Of them, 73 (60.8%) were male and 47 (39.2%) were female. Chest US showed positive findings in 116 (96.7%) patients, with a sensitivity of 97.4%, specificity of 25%, and accuracy of 95%. There was a highly significant difference (P<0.001) between chest US and plain chest radiography in detecting pneumonia, whereas there was no significant difference (P>0.5) between chest US and chest computed tomography. Chest US had a high significant difference (P<0.001) in detecting minimal pleural effusion over plain radiography. Moreover, it had a sensitivity of 93.8%, specificity of 99%, and accuracy of 98.3% in detecting complex septated pleural effusion. Improvement in pneumonia was detected in 111 patients (95.7%) with chest US, whereas improvement was detected in 76 (75.2%) patients with plain chest radiography after 14 days; this was highly significant (P<0.001). Conclusion Chest US is a quick, bedside, noninvasive, nonionizing, and highly sensitive tool to detect and follow-up cases of pneumonia and parapneumonic effusion.

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