الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Pneumonia is considered a major healthcare problem that has a huge effect on the morbidity and mortality globally. It is considered one of the leading causes of death worldwide.
Any delay or failure in the diagnosis or management of pneumonia causes significant increase in mortality. Meanwhile, inappropriate antibiotic leads to the development of antibiotic resistance.
Traditionally, the diagnosis of pneumonia is based on clinical examination, laboratory data, imaging techniques, and cultures. Clinical information alone is not sufficient to predict pneumonia.
Chest X-ray (CXR) is the easiest approach in patients with suspected pneumonia, in search for a new infiltrate. However, studies clarified that it has low sensitivity for the diagnosis of pneumonia in comparison to chest computed tomography (CT). But the use of chest CT is not commonly used except for complex cases and cases with failure response to treatment. Lung ultrasonography (LUS), being a fast bedside technique, it has attracted many interests to preform studies to assess its ability to detect pleuropulmonary pathologies generally and pneumonia specifically.
The aim of this study was to assess the diagnostic accuracy of emergency ultrasonography (US) in the diagnosis of pneumonia when compared to computed tomography (CT).
This was a prospective observational study where 150 patients completed the study, with mean age of 52.5 years and more females (56.7%). After US assessment for the diagnosis of pneumonia, chest CT was done to confirm the diagnosis. Accordingly, they were divided into 2 groups. One hundred and three patients (68.67%) were diagnosed with pneumonia “Positive CT group”. Forty-seven patients (31.33%) were not diagnosed with pneumonia “Negative CT group”.
After plotting ROC curve for the data obtained from US in the diagnosis of pneumonia in comparison to the chest CT as a gold standard, US was considered a valuable tool to detect the diagnosis of pneumonia (AUC=0.910, 95% CI: 0.855 – 0.964, p ˂0.001). It had extremely adequate results with sensitivity (88.35%) and specificity (93.62%). It showed excellent accuracy of 90%.
The presence of one of the following four profiles in the ultrasound:
(A + PLAPS, A/B, B’ or C profile) was used in the diagnosis. A + PLAPS profile showed 37.86% and 93.62% for sensitivity and specificity, respectively, A/B profile 21.36% and 100%, B’ profile: 8.7% and 100%, and C profile: 20.39% and 100%.
Form the results of this study, emergency ultrasonography showed adequate sensitivity and high specificity; and that it might be valuable complement to the standard diagnosis of pneumonia in emergency settings. Our recommendations are, further larger multicentric studies to study both the application of BLUE protocol in the diagnosis of dyspnea in ED and the ability to identify the different lung pathologies in cases of overlapping diagnoses. It is also recommended to apply multiple training programmes to increase the use of US among emergency physicians.