Point-of-care ultrasound is more accurate than the stethoscope in diagnosing pneumonia in children

December 10, 2012

Point-of-care ultrasound is more accurate than the traditional method of auscultation by stethoscope in diagnosing pneumonia in children and young adults, and can even detect small pneumonias that a chest x-ray may miss, a Mount Sinai researcher reports in an article titled, "Prospective Evaluation of Point-of-Care Ultrasonography for the Diagnosis of Pneumonia in Children and Young Adults" in the online edition of Archives of Pediatrics & Adolescent Medicine published December 10, 2012.

These findings have important public health implications, especially in the developing world, as is the leading cause of death in worldwide. Pneumonia kills an estimated 1.2 million children under the age of five years every year – more than AIDS, malaria and tuberculosis combined.

"The World Health Organization has estimated as many as three-quarters of the world's population, especially in the developing world, does not have access to any diagnostic imaging, such as chest x-ray, to detect pneumonia," said senior author James Tsung, MD, MPH, Associate Professor of Emergency Medicine and Pediatrics at Mount Sinai School of Medicine. "Many children treated with antibiotics may only have a viral infection— not pneumonia. Portable machines can provide a more accurate diagnosis of pneumonia than a ."

Dr. Tsung of Mount Sinai, along with collaborators Vaishali Shah, MD of the Children's Hospital at Montefiore and Michael G. Tunik, MD of Bellevue Hospital Center/NYU School of Medicine, studied 200 patients from birth to 21 years of age who were presented to the emergency department with suspected community acquired pneumonia at Bellevue Hospital Center from 2008-2010. The criteria for inclusion were patients requiring a chest x-ray for evaluation. Sonologists, clinicians who perform and interpret ultrasonography, were given one hour of focused training prior to the start of the study on the use the to diagnose pneumonia.

Researchers found point-of-care ultrasound to be highly specific (97 percent) for diagnosing pneumonia, with sensitivity as high as 92 percent that can be achieved with training and experience. The accuracy for diagnosing pneumonia with the stethoscope was lower: specificity ranged from 77-83 percent, and sensitivity at 24 percent.

Further analysis of the data at Mount Sinai Medical Center revealed that ultrasound was able to identify pneumonia too small (less than 1 centimeter) for a to detect in 12 out of 48 patients with confirmed pneumonia.

Dr. Tsung and colleagues noted that diagnosing pneumonia with a stethoscope can be more difficult when a patient is wheezing or has co-existing diseases like asthma or bronchiolitis. This is not a problem for ultrasound.

Pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli. The alveoli fill with air when a healthy person breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake.

Explore further: Vitamin D deficiency in pneumonia patients associated with increased mortality

Related Stories

Vitamin D deficiency in pneumonia patients associated with increased mortality

May 10, 2011
A new study published in the journal Respirology reveals that adult patients admitted to the hospital with pneumonia are more likely to die if they have Vitamin D deficiency.

Glucose levels at admission predict death in pneumonia

May 30, 2012
(HealthDay) -- For patients with community-acquired pneumonia without preexisting diabetes, serum glucose levels at admission are predictive of death at 28 and 90 days, according to a study published online May 29 in BMJ.

Recommended for you

Google searches can be used to track dengue in underdeveloped countries

July 20, 2017
An analytical tool that combines Google search data with government-provided clinical data can quickly and accurately track dengue fever in less-developed countries, according to new research published in PLOS Computational ...

MRSA emerged years before methicillin was even discovered

July 19, 2017
Methicillin resistant Staphylococcus aureus (MRSA) emerged long before the introduction of the antibiotic methicillin into clinical practice, according to a study published in the open access journal Genome Biology. It was ...

New test distinguishes Zika from similar viral infections

July 18, 2017
A new test is the best-to-date in differentiating Zika virus infections from infections caused by similar viruses. The antibody-based assay, developed by researchers at UC Berkeley and Humabs BioMed, a private biotechnology ...

'Superbugs' study reveals complex picture of E. coli bloodstream infections

July 18, 2017
The first large-scale genetic study of Escherichia coli (E. coli) cultured from patients with bloodstream infections in England showed that drug resistant 'superbugs' are not always out-competing other strains. Research by ...

Ebola virus can persist in monkeys that survived disease, even after symptoms disappear

July 17, 2017
Ebola virus infection can be detected in rhesus monkeys that survive the disease and no longer show symptoms, according to research published by Army scientists in today's online edition of the journal Nature Microbiology. ...

Mountain gorillas have herpes virus similar to that found in humans

July 13, 2017
Scientists from the University of California, Davis, have detected a herpes virus in wild mountain gorillas that is very similar to the Epstein-Barr virus in humans, according to a study published today in the journal Scientific ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

Team Chad
not rated yet Dec 11, 2012
The leaders in the medical field are chasing after a costly solution for the problem. Advanced passive acoustic sensors coupled with smart systems can solve most of the problems associated with the drawbacks of auscultation, including accurately identifying pneumonia.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.