A comparative study of x-ray chest and lung ultrasonography characteristics among community acquired pneumonia in children

Abstract

Background: Pneumonia is the leading cause of childhood morbidity and mortality worldwide. Each year, approximately 1.6 million children die from pneumonia. According to the estimates of the World Health Organization (WHO), pneumonia accounts for almost one-fifth of overall childhood mortality Methods: The study was conducted in Department of Paediatric Medicine, SMS Medical College, Jaipur. Study Design: This study is a
Hospital based analytical type of observational study, Sample size:139 patients. Inclusion criteria: Children between 2 months to 18 years admitted with suspicion for pneumonia on the basis of sign and symptoms were enrolled. Results: Mean age of study subjects was 3.28 ± 0.62 years with median age was 1.5 years. Out of these, 48 (34.5%) were female and 91 (65.5%) were male. Majority 75(53.95%) of patients were below 5th centile of their
weight for age, almost all 138 (99.23%) patients had tachypnoea on clinical examination. According to Chest X-ray findings, 97 (69.78%) patients had consolidation, 12 (8.63%) had peribronchial thickening, 7 (5.03%) had pleural effusion while 2 (1.43%) had consolidation as well as peribronchial thickening and 8 (5.75%) had both pleural effusion and consolidation. On LUS findings on day-1,43 (30.93%) patients had sub pleural lung consolidation, 44 (31.65%)had confluent B-line with consolidation. 2 (1.43%) had confluent B- Lines with pleural line abnormalities. 22 (15.82%) had consolidation with pleural line abnormalities. 21 (15.01%) had pleural effusion with consolidation while 3 (2.15%) had focal or multiple confluent B-line and only 1 (0.72%) had confluent B-line with pleural effusion. 3 (2.15%) patients had no changes in their lung ultrasound. Consolidation was reported in 130 (93.52%) patients. LUS characteristic findings reported that 97 (71.3%) patients had involvement of right lung, 26 (19.1%) patients had involvement of left lung and 13 (9.6%) had involvement of bilateral lung fields. The two characteristic findings common in chest X-ray and LUS are consolidation and pleural effusion. Consolidation was reported in LUS findings of 130 (93.53%) patients and chest X-ray findings of 107 (76.97%) patients. this difference was statistically significant. Conclusion: Though chest radiograph (CXR) has been considered the 'gold standard for the diagnosis of pneumonia in children, Lung ultrasound (LUS) is a very easy and versatile application. It is rapid, portable, repeatable, and non-ionizing.