Lung ultrasound in diagnosis and follow up of community acquired pneumonia in infants younger than 1-year old

2018 ◽  
Vol 12 (7) ◽  
pp. 2204-2211 ◽  
Author(s):  
Ahmed Omran ◽  
Samah Eesai ◽  
Mostafa Ibrahim ◽  
Sonya El-Sharkawy
Keyword(s):  
Lung Ultrasound ◽  
Community Acquired Pneumonia

scholarly journals Effectiveness of Lung Ultrasound in Comparison with Chest X-Ray in Diagnosis of Lung Consolidation

2019 ◽  
Vol 7 (15) ◽  
pp. 2457-2461
Author(s):  
Youssef Ibrahim Haggag ◽  
Karim Mashhour ◽  
Kamal Ahmed ◽  
Nael Samir ◽  
Waheed Radwan
Keyword(s):  
Lung Ultrasound ◽  
Community Acquired Pneumonia ◽  
P Value ◽  
Initial Examination ◽  
X Ray ◽  
Chest Ultrasound ◽  
Lung Consolidation ◽  
Plain Chest ◽  
Chest X Ray

BACKGROUND: Lung ultrasound (US) is an available and inexpensive tool for the diagnosis of community-acquired pneumonia (CAP); it which has no hazards of radiation and can be easily used. AIM: To evaluate the efficacy of lung ultrasound in the diagnosis and follow-up of CAP. PATIENTS AND METHODS: 100 patients aged from 40 to 63 years with a mean age of 52.3 ± 10 years admitted to the Critical Care Department, Cairo University with pictures of CAP. Lung US was performed for all patients initially, then a plain chest X-ray (CXR) was performed. Another lung ultrasound was performed on the 10th day after admission. RESULTS: Initial chest X-ray was correlated with the initial chest ultrasound examination in CAP diagnosis (R-value = 0.629, P < 0.001). Cohen's κ was run to determine if there is an agreement between the findings of the initial chest X-ray findings and those of the initial chest ultrasound in CAP diagnosis. A moderate agreement was found where κ = .567 (95% CI, 0.422 to 0.712) and P < 0.001. Upon initial examination, the CXR diagnosed CAP in 48.0% of patients, while lung US diagnosed the disease in 70% of patients. Moreover, lung US was more sensitive than CXR (P-value < 0.001). Compared to the accuracy of computed tomography (CT) chest (100%) which is the gold standard for CAP diagnosis, the accuracy of lung US was 95.0%, while the accuracy of CXR was 81.0%. CONCLUSION: This study proved the effectiveness of lung ultrasound in CAP diagnosis.

The role of lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia

2012 ◽  
Vol 23 (5) ◽  
pp. 391-397 ◽  
Author(s):  
Angelika Reissig ◽  
Andrea Gramegna ◽  
Stefano Aliberti
Keyword(s):  
Lung Ultrasound ◽  
Community Acquired Pneumonia

Lung Ultrasound in the Diagnosis and Follow-up of Community-Acquired Pneumonia

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 965-972 ◽  
Author(s):  
Angelika Reissig ◽  
Roberto Copetti ◽  
Gebhard Mathis ◽  
Christine Mempel ◽  
Andreas Schuler ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Community Acquired Pneumonia

scholarly journals The Usefulness of Lung Ultrasound for the Aetiological Diagnosis of Community-Acquired Pneumonia in Children

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Vojko Berce ◽  
Maja Tomazin ◽  
Mario Gorenjak ◽  
Tadej Berce ◽  
Barbara Lovrenčič
Keyword(s):  
Diagnostic Tool ◽  
Lung Ultrasound ◽  
Community Acquired Pneumonia ◽  
Laboratory Findings ◽  
Different Types ◽  
Median Diameter ◽  
Aetiological Diagnosis

AbstractThe aetiology of community-acquired pneumonia (CAP) is not easy to establish. As lung ultrasound (LUS) has already proved to be an excellent diagnostic tool for CAP, we analysed its usefulness for discriminating between the aetiologically different types of CAP in children. We included 147 children hospitalized because of CAP. LUS was performed in all patients at admission, and follow-up LUS was performed in most patients. LUS-detected consolidations in viral CAP were significantly smaller, with a median diameter of 15 mm, compared to 20 mm in atypical bacterial CAP (p = 0.05) and 30 mm in bacterial CAP (p < 0.001). Multiple consolidations were detected in 65.4% of patients with viral CAP and in 17.3% of patients with bacterial CAP (p < 0.001). Bilateral consolidations were also more common in viral CAP than in bacterial CAP (51.9% vs. 8.0%, p < 0.001). At follow-up, a regression of consolidations was observed in 96.6% of patients with bacterial CAP and in 33.3% of patients with viral CAP (p < 0.001). We found LUS to be especially suitable for differentiating bacterial CAP from CAP due to other aetiologies. However, LUS must be interpreted in light of clinical and laboratory findings.

Characterization of lung ultrasound imaging in preterm infants with bronchopulmonary dysplasia

2021 ◽  
pp. 1-13
Author(s):  
Ying-Hua Sun ◽  
Lin Yuan ◽  
Yang Du ◽  
Jian-Guo Zhou ◽  
Sam Bill Lin ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Imaging Method ◽  
Chronic Lung Diseases ◽  
Pleural Line ◽  
Ultrasound Features

BACKGROUND: Lung ultrasound (LUS) is a bedside technique that can be used on diagnosis and follow-up of neonatal respiratory diseases. However, there are rare reports on the ultrasound features of bronchopulmonary dysplasia (BPD) which is one of the most common chronic lung diseases in preterm infants. OBJECTIVE: To describe the ultrasound features of different BPD levels, and to investigate the value of ultrasound in evaluating moderate-to-severe BPD. METHODS: In this prospective cohort study, newborns of less than 37 weeks’ gestational age in neonatal intensive care unit (NICU) were included. The LUS characteristics including pleural line, alveolar-interstitial syndrome (AIS), retrodiaphragmatic hyperechogenicity and diaphragmatic morphology were observed and recorded. The reliability of LUS in evaluating moderate and severe BPD were compared and calculated. RESULTS: A total of 108 infants were enrolled in our study: 39, 24, 29, 16 infants had non, mild, moderate and severe BPD. The median(IQR) pleura thickness in the moderate-to-severe BPD group was 1.7(1.6–1.85) mm, which was thicker than that in the none-to-mild BPD infants (P <  0.001), meanwhile the proportions of rough pleural lines, diffuse AIS, retrodiaphragmatic hyperechogenicity, small cysts above the diaphragm and rough diaphragm in the moderate-to-severe BPD group were also higher than those in none-to-mild BPD group (86.7% vs 36.5, 57.8% vs 7.9%, 37.8% vs 0, 33.3% vs 0, P <  0.001). In evaluating moderate-to-severe BPD, rough pleura had 91.1% (95% confidence interval [CI]: 0.793–0.965) in sensitivity, 91.3% (95% CI: 0.797–0.966) in negative predictive value (NPV), and 66.7% (95% CI: 0.544–0.771) in specificity. Small cysts had 100% (95% CI: 0.941-1) in specificity, 100% (95% CI: 0.816-1) in PPV, and 37.8% in sensitivity (95% CI: 0.251–0.524). Rough diaphragm had 100% (95% CI: 0.943-1) in sensitivity, 100% (95% CI: 0.796-1) in PPV and 33.3% (95% CI: 0.211–0.478) in specificity. CONCLUSIONS: Depending on its unique advantages such as convenient, no radiation and repeatable, LUS is a valuable imaging method in assessing the severity of BPD, especially in moderate and severe BPD.

scholarly journals A single cycle of 2-chlorodeoxyadenosine results in complete remission in the majority of patients with hairy cell leukemia

Blood ◽  
1992 ◽  
Vol 80 (9) ◽  
pp. 2203-2209 ◽  
Author(s):  
MS Tallman ◽  
D Hakimian ◽  
D Variakojis ◽  
D Koslow ◽  
GA Sisney ◽  
...  
Keyword(s):  
Complete Remission ◽  
Interferon Alpha ◽  
Hairy Cell Leukemia ◽  
Complete Recovery ◽  
Community Acquired Pneumonia ◽  
Hairy Cell ◽  
Cell Leukemia ◽  
Single Cycle ◽  
Severe Pancytopenia

Abstract Twenty-six patients with hairy cell leukemia (HCL) were treated with 2- chlorodeoxyadenosine (2-CdA), a purine analogue resistant to adenosine deaminase, at 0.1 mg/kg/d for 7 days by continuous intravenous infusion. Fifteen patients were previously untreated, while 11 patients had received prior treatment with splenectomy alone (three patients), interferon alpha alone (four), splenectomy, then interferon alpha (two), or splenectomy, interferon alpha, then 2-deoxycoformycin (2-DCF) (two). Sixteen (80%) of 20 patients evaluable at 3 months achieved complete remission (CR), and four (20%) achieved partial remission (PR) following a single cycle of therapy. All four patients in PR had complete recovery of their peripheral blood counts (except one patient whose platelet count remained 84,000/microL), but had residual HCL in the bone marrow (three patients) or residual splenomegaly (one). Patients with bulky adenopathy, massive splenomegaly, and severe pancytopenia responded as well as those with only modest marrow involvement. The three patients with residual marrow disease received a second cycle of 2-CdA, and two have attained CR. Therefore, 18 of 20 (90%) achieved CR with either one or two cycles of therapy. No patient achieving CR has relapsed at a median follow-up of 12 (+/- 2.1) months. Toxicities included myelosuppression and culture-negative fever. A community-acquired pneumonia was the only infectious complication. Since a single cycle of 2-CdA induces sustained CR in the vast majority of patients with minimal toxicity, this agent is emerging as the treatment of choice for all patients with HCL.

scholarly journals Utility of procalcitonin, C-reactive protein and white blood cells alone and in combination for the prediction of clinical outcomes in community-acquired pneumonia

2015 ◽  
Vol 53 (4) ◽  
Author(s):  
Andriy Zhydkov ◽  
Mirjam Christ-Crain ◽  
Robert Thomann ◽  
Claus Hoess ◽  
Christoph Henzen ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Blood Cells ◽  
White Blood Cells ◽  
Community Acquired Pneumonia ◽  
Adverse Clinical Outcome ◽  
C Reactive Protein ◽  
Prognostic Information ◽  
Reactive Protein

AbstractThe added value of biomarkers, such as procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC), as adjuncts to clinical risk scores for predicting the outcome of patients with community-acquired pneumonia (CAP) is in question. We investigated the prognostic accuracy of initial and follow-up levels of inflammatory biomarkers in predicting death and adverse clinical outcomes in a large and well-defined cohort of CAP patients.We measured PCT, CRP and WBC on days 1, 3, 5, and 7 and followed the patients over 30 days. We applied multivariate regression models and area under the curve (AUC) to investigate associations between these biomarkers, the clinical risk score CURB-65, and clinical outcomes [i.e., death and intensive care unit (ICU) admission].Of 925 patients with CAP, 50 patients died and 118 patients had an adverse clinical outcome. None of the initial biomarker levels significantly improved the CURB-65 score for mortality prediction. Follow-up biomarker levels showed significant independent association with mortality at days 3, 5, and 7 and with improvements in AUC. Initial PCT and CRP levels were independent prognostic predictors of adverse clinical outcome, and levels of all biomarkers during the course of disease provided additional prognostic information.This study provides robust insights into the added prognostic value of inflammatory markers in CAP. Procalcitonin, CRP, and to a lesser degree WBC provided some prognostic information on CAP outcomes, particularly when considering their kinetics at days 5 and 7 and when looking at adverse clinical outcomes instead of mortality alone.

scholarly journals Quick diagnostic and management community acquired pneumonia at Sumbawa hospital: a case report

2018 ◽  
Vol 7 (1) ◽  
pp. 297
Author(s):  
Muhammad Ahmad Syammakh ◽  
Elim Jusri ◽  
Gede Agung Setya ◽  
Made Aryadi Sukartika
Keyword(s):  
Emergency Department ◽  
Lung Ultrasound ◽  
Lower Lobe ◽  
Symptomatic Treatment ◽  
Community Acquired Pneumonia ◽  
Pulmonary Parenchyma ◽  
The Right ◽  
Hospital Acquired ◽  
B Lines ◽  
Good Oxygenation

Pneumonia is most common cause of respiratory distress an infection of the pulmonary parenchyma. Despite being the cause of significant morbidity and mortality, it is often misdiagnosed, mistreated, and underestimated. Pneumonia historically was Typically classified as community-acquired (CAP), hospital-acquired (HAP), or ventilator-associated (VAP). A 68-year-old male was sent to the emergency department from clinic with an oxygen saturation of 86%. She has fevers with cough and generalized weakness for one week. She had been evaluated by her primary care provider on day two of illness and was started empirically on cefixime without improvement of her symptoms. The patient arrived febrile, tachycardic, tachypneic, and hypoxic on room air with right-sided crackles on exam. Lung Ultrasound of the right lower lobe demonstrates lung hepatization, a classic finding for pneumonia. In addition, a shred sign is present with both air bronchograms and focal B lines-all suggestive of poorly aerated, consolidated lung. Authors critically evaluate the evidence for the use lung ultrasound for rapid diagnostic. It is important to understand this disease, rapid diagnostic with ultrasound and when treated promptly and effectively, these patients will rapidly recovery. Good oxygenation, intravenous Antibiotic, intravenous fluids and symptomatic treatment which should be started within minutes of the patients’ arrival to emergency department.

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