Background: Bronchiolitis is a lower respiratory tract infection (LRTI), resulting from the inhalation of virus-containing droplets. Chest ultrasound is not considered in the diagnostic algorithm for assessment of pneumonia in children with acute bronchiolitis even though its usefulness has been tested in several studies in the last years as an emerging diagnostic tool. Objective: The aim of the present study was to assess the diagnostic accuracy of lung ultrasound (LUS) for the detection of pneumonia in children with acute bronchiolitis.
Patients and methods: This cross-sectional study included children from birth to 24 months of age admitted to Pulmonology and Allergy Unit, Pediatric Hospital of Zagazig University. Children were diagnosed with bronchiolitis according to the American Academy of Pediatrics guideline. All patients underwent posteroanterior chest X-ray (CXR) because of clinical suspicion of concomitant bacterial pneumonia, persistent oxygen saturation (SatO₂) < 90%, and asymmetric breath sounds on auscultation.
Results: The mean age of the studied cases was 4.19 months and 86.7% of them were from 1 to 6 months. The most common clinical findings among the studied group was wheezes (96.7%) followed by fever (60%). 63.3% of the studied group had moderate respiratory distress, 26.7% had mild and 10% had severe. Abnormal findings of X-ray were peri-bronchial thickening, lung consolidation and hyperinflation (13.3%, 13.3% and 10% respectively). Abnormal findings of ultrasound were compact B line, subpleural lung consolidation and irregular pleural lines (53.3%, 26.7% and 3.3% respectively).
Conclusion: Lung ultrasonography is more accurate and sensitive than chest X-ray to diagnose suspected cases of pneumonia in the pediatric age group. LUS is a sensitive and highly specific diagnostic tool in children with community-acquired pneumonia (CAP).