Chest ultrasound as a differentiating modality between pneumonia and pulmonary edema

Abstract

Background
Chest ultrasound is still impressing physicians with its capabilities in variable lung disorders.


Aim
To assess the effectiveness of chest ultrasound as a diagnostic and a differentiating modality in cases of pneumonia and pulmonary edema. It also evaluates chest sonography effectiveness in follow-up of patients with pneumonia and pulmonary edema.


Patients and methods
Chest ultrasound, chest radiograph, and computed tomography (CT) chest were performed on patients on their arrival, as well as on day 7 and 14 of admission. Patients were divided into group 1, which included 30 patients with clinically consistent signs of pneumonia based on respiratory signs and symptoms in accordance with the American Thoracic Society guidelines 2016, and group 2, which included 15 patients with clinically consistent signs of pulmonary edema.


Results
The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ultrasound in the follow-up of pneumonia and pulmonary edema were 100% each. The sensitivity, specificity, PPV, NPV, and accuracy of chest radiograph in the follow-up of pneumonia on day 7 were 100, 90, 81.2, 100, and 93.1%, respectively, but for pulmonary edema were 91.7, 66.7, 91.7, 66.7, and 86.7%, respectively. However, the sensitivity, specificity, PPV, NPV, and accuracy of CT chest in the follow-up of pneumonia on day 7 were 88.9, 100, 100, 95.2, and 96.6%, respectively, whereas the sensitivity, specificity, PPV, NPV, and accuracy of CT chest in the follow-up of pulmonary edema on day 7 were 33.3, 100, 85.7, 100, and 86.7%, respectively.


Conclusion
Chest ultrasound might be a dependable method in the diagnosis and follow-up of pneumonia cases as well as differentiating pulmonary edema, both cardiogenic and noncardiogenic.