Ultrasound Monitoring and Age Sonographic Characteristics of Community-Acquired Pneumonia in Children

Abstract

The aim of the investigation was to study ultrasound semiotics of community-acquired pneumonias in children of different age, and its dynamics in the course of treatment. Materials and Methods. Pneumonia semiotics study and dynamic monitoring of the disease have been carried out on the basis of chest ultrasound of 154 children divided into 4 age groups: 14 infants (9.1%) from birth to 3 months; 60 children (39.0%) from 3 months to 3 years of age; 49 children (31.8%) from 4 to 7 years of age; 31 children (20.1%) from 7 to 18 years of age. During the hospital stay the children underwent ultrasound at least three times: on admission to determine pneumonia volume and localization; on day 3–5 or day 5–7 to assess the dynamics of sonographic picture and the necessity of etiotropic therapy change; before discharge to evaluate residual effects and determine the follow-up strategy. Ultrasound revealed zones of airness impairment of various size in the pulmonary tissue of all children. Pneumonia semiotics presented extensive and lobar forms of pneumonia. An extensive type occupies a segment or a lobe, and looks like a delta-shaped air-free area with fuzzy contours and heterogeneous structure, with an air echobronchogram, and occurs in children of older age. Lobar pneumonia presents small rounded subpleural infiltrate up to 15 mm with a homogeneous hypoechogenic structure, and is typical of newborns and younger children. The size and echostructure of apneumatic (air-free) area were the assessment criteria of pneumonia regression. Conclusion. Chest ultrasound is an informative radiologically safe technique for diagnosing and dynamic control of pneumonia in children of different age, which enables timely assessment of etiotropic therapy efficacy.