Volume 6 Supplement 2

7th WINFOCUS Italian Congress on Ultrasound in Emergency, Anaesthesiology and Critical Care

Open Access

The role of lung ultrasound in the diagnosis of pneumonia in acutely ill patients

Critical Ultrasound Journal20146(Suppl 2):A2


Published: 27 August 2014


PneumoniaEmergency DepartmentHospital StayDifferential DiagnosisEarly Diagnosis


The differential diagnosis of patients in the emergency department who show symptoms of sepsis and suspected pneumonia may be difficult because of the low sensitivity and specificity of supine chest X rays (SCXR) and physical examination.


A retrospective assessment of the usefulness of lung ultrasound (LU) in the diagnosis of pneumonia in patients with signs and symptoms of sepsis and respiratory disease.

Patients and methods

2 groups of patients were considered:

Group A: 22 patients with a positive first SCXR (SCXR1) for pneumonia

Group B: 18 patients with a negative SCXR1 for pneumonia, but who were subsequently diagnosed with pneumonia during their hospital stay following a second SCXR (SCXR2) or CT.

Lung ultrasound examination was performed within 24 hours of admission, searching for direct and indirect echographical signs of pneumonia: focal B lines (FBL), pleural effusion (PE) and images of lung consolidation (LC).


See table 1.

Table 1


Group A (%)

Group B (%)







SCXR1 pos



SCXR2 or CT pos



FBL pos

9 (41)

10 (50)

FBL neg

13 (59)

10 (50)

PE pos

17 (78)

16 (80)

PE neg


4 (20)

LC pos

19 (87)


LC neg

3 (13)

0 (0)

LC pos or FBL pos

21 (95)


LU impact on therapy


20 (100)


In our observational study, LU showed high sensitivity in the diagnosis of pneumonia:

95% in patients already diagnosed using SCXR, and 100 % of early diagnosis of pneumonia in patients whose diagnosis was subsequently confirmed during hospitalization.

Authors’ Affiliations

Medicina 1 dept, Ospedale San Carlo Borromeo, Milano, Italy
Medicina d’ Urgenza, Ospedale San Carlo Borromeo, Milano, Italy


  1. Lichtenstein DA: Relevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure - The Blue Protocol. Chest 2008, 134: 117–125. 10.1378/chest.07-2800PubMed CentralPubMedView ArticleGoogle Scholar
  2. Essayag Y, et al.: Diagnostic value of chest radiographs in bedridden patients suspected of having pneumonia. Am J Med 2010, 123: 88. e 1–5.Google Scholar
  3. Reissig A: Sonographic Diagnosis and Follow-up of Pneumoniai: A Prospective Study. Respiration 2007, 74: 537–547. 10.1159/000100427PubMedView ArticleGoogle Scholar
  4. Mathis G: Thoraxsonography – Part II: Peripheral Pulmonary Consolidation. Ultrasound in Med. & Biol 1997,23(8):1141–1153. 10.1016/S0301-5629(97)00111-7View ArticleGoogle Scholar
  5. Volpicelli G: Detection of sonographic B lines in patients with normal lungs or radiographic alveolar consolidation. Med Sci Monitor 2008,14(3):CR 122–128.Google Scholar


© Biancardi et al; licensee Springer 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.