Lung ultrasonography for community-acquired pneumonia diagnosis - 04/09/25

Doi : 10.1016/j.idnow.2025.105129

D. Basille ^a,^b,^c,^d,^⁎ , Y. Tandjaoui-Lambiotte ^b,^e,^f,^g, M. Blot ^h,ⁱ, P. Fillatre ^j, A. Dinh ^k, C. De Margerie ^l
^a Service de Pneumologie, CHU Amiens-Picardie, Amiens, France
^b GREPI, groupe de recherche et d’enseignement en pneumo-infectiologie, Société de Pneumologie de Langue Française, Paris, France
^c G-ECHO, groupe échographie thoracique du pneumologue, Société de Pneumologie de Langue Française, Paris, France
^d AGIR unit – UR4294, université Picardie Jules Verne, Amiens, France
^e Service de Pneumologie et Infectiologie, Hôpital Delafontaine, 93200 Saint Denis, France
^f INSERM UMR 1137 IAME, 75018 Paris, France
^g INSERM UMR 1272 Hypoxie et Poumon, 93000 Bobigny, France
^h Département d’infectiologie, Hôpital Universitaire Dijon-Bourgogne, Dijon, France
ⁱ INSERM Research Centre LNC-UMR1231, Université de Bourgogne, Dijon, France
^j Service de Médecine Intensive et Réanimation, Hôpital Yves le Foll, Saint Brieuc, France
^k Service de Maladies Infectieuses, CHU R. Poincaré, APHP, France
^l Université Paris Cité, PARCC UMRS 970, INSERM, AP-HP, Hôpital Saint-Louis, Department of Radiology, Paris 75010, France

^⁎Corresponding author at: Service de Pneumologie – CHU Amiens-Picardie, 1, Rue du Professeur Christian Cabrol, 80054 AMIENS, France.Service de Pneumologie – CHU Amiens-Picardie1, Rue du Professeur Christian Cabrol80054 AMIENSFrance

Highlights

•	Ultrasonography is a reliable tool for the diagnosis of pneumonia.
•	Ultrasonography is more sensitive and specific than x-ray.
•	Ultrasonography can be used as an alternative to x-ray for community-acquired acute pneumonia diagnosis.
•	Prior training is required before using this tool.

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Abstract

Over the past two decades, several studies have assessed the performance of lung ultrasonography in the diagnosis of community-acquired pneumonia (CAP). The performance of this diagnostic tool, when used by clinicians other than radiologists, is excellent, with an area under the curve of 0.97, 92% sensitivity, and 93% specificity according to a recent meta-analysis including 5,108 patients. When ultrasonography is compared with chest CT-scan, sensitivity ranged from 68% to 98% and specificity from 61% to 98%. Compared with chest x-ray, ultrasonography seems more sensitive and specific. Lung ultrasonography can thus be considered a reliable tool for the diagnosis of CAP and may serve as a first-line imaging modality, provided that operators have received adequate training. Lung ultrasonography is particularly indicated in patients with acute respiratory failure, as good quality chest x-ray is difficult to perform in these patients. When diagnostic uncertainties remain after this radiological and clinical evaluation, low-dose chest CT-scan is recommended.

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Keywords : Community-acquired pneumonia, Lung ultrasonography, Chest x-ray, Chest CT-scan