Imaging |

Role of Transthoracic Ultrasound in Diagnosis and Follow-up of CAP in the Emergency Department FREE TO VIEW

Gamal Agmy, MD; Yasser Gad, MD; Sherif Mohamed, MD
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Assiut University, Assiut, Egypt

Chest. 2014;146(4_MeetingAbstracts):582A. doi:10.1378/chest.1969307
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SESSION TITLE: Ultrasound and Other Imaging Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The aim of this prospective study was to define the accuracy of transthoracic ultrasound (TUS) in the diagnosis and follow up of community-acquired pneumonia (CAP) in the emergency department (ED).The role of C-reactive protein in follow up of CAP was evaluated.

METHODS: This study included 284 patients with suspected CAP. During admission to ED, history, clinical examination, laboratory testing, and TUS were performed as well as chest radiograph (CXR) in two planes and CT Chest scan. In patients with CAP, follow-up was arranged.

RESULTS: CAP was confirmed in 260 patients (92%). TUS revealed a sensitivity of 97% and 98% for specificity, positive predictive value or negative predictive value. In patients with CAP,TUS demonstrated subpleural consolidation in 85% , an air bronchogram, in 82% ,B lines in 70% and a basal pleural effusion in 50% of cases. CXR clarified CAP with a sensitivity of 85% and specificity of 94%, positive predictive value of 85% and negative predictive value of 90%.CXR missed pleural effusion in 15% of cases. During follow-up, C-reactive protein levels decreased from 157 mg/dL to 5.5 mg/dL at days 10 to 15 as did signs of CAP.

CONCLUSIONS: TUS is a simple and reliable imaging tool, superior to CXR in identifying CAP in ED. During the course of the disease, TUS allows a radiation-free follow-up of pleuro-pulmonary abnormalities.C-reactive protein is a useful marker for following CAP.

CLINICAL IMPLICATIONS: TUS is an excellent imaging tool in diagnosis and follow up of CAP with very good sensitivity and specificity exceeding that of CXR. It has the advantages of simplicity, loss of ionizing radiation, bedside availability and both diagnosis and treatment can be established immediately.C-reactive protein is a useful marker for follow up of pnemonia.

DISCLOSURE: The following authors have nothing to disclose: Gamal Agmy, Yasser Gad, Sherif Mohamed

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