Abstract:
Community-acquired pneumonia in children (CAP) continues to be a
significant cause of morbidity and mortality worldwide, accounting for 13% of
infectious diseases in children under 2 years of age and the cause of over
800,000 infant deaths annually. Despite current guidelines, chest radiography
(CXR) is still mainly used for imaging diagnosis of mild and/or uncomplicated
cases of CAP in children.
Aim: The aim of the study is to evaluate the contribution and reliability
of pediatric lung ultrasound (PLUS) as an alternative test in the diagnosis of
CAP in children.
Methods: This retrospective study included 280 children diagnosed with
CAP between June 2022 and February 2024, aged between 1 month and 13
years, conducted at the Municipal Children's Clinical Hospital No. 1
Results: CAP in children was confirmed through clinical methods, as
well as CXR and PLUS investigations in 280 children. LUS showed
pathological changes in 226 patients (80.71%), while CXR was abnormal in
223 (79.64%) cases. In radiologically diagnosed pneumonia, PLUS detected
CAP in 205 out of 223 cases (91.92%); when CXR was normal, PLUS was
abnormal in 21 out of 57 cases (36.84%). PLUS showed a sensitivity of 91.93%
(95% CI: 87.54-95.15), specificity of 63.16% (95% CI: 49.34-75.56), compared
to a sensitivity of 79.5% (95% CI: 72.43-84.06) and specificity of 63.15%
(95% CI: 49.32-75.49) for CXR. The positive predictive value was 90.71%
(95% CI: 87.40-93.22) and negative predictive value was 66,67% (95% CI:
55.18-76.47).The accuracy was 86.07% (95% CI: 81.45-89.90) for diagnosing
CAP by PLUS in children.
Conclusion: Pediatric lung ultrasound can be considered a valid
alternative first-line diagnostic tool for CAP in children.
