Lung ultrasound and digital auscultation for discrimination between viral and non-viral respiratory illnesses
BACKGROUND: Acute lower respiratory infection (ALRI) is the leading cause of death in children under 5 years of age, and the majority of deaths occur in low and middle-income countries. Distinguishing between viral and bacterial causes of ALRI is challenging due to the overlap in clinical features between these illnesses, but is important in making correct management decisions.
GAP: Lung ultrasound (LUS) is a promising tool for distinguishing between types of ALRI, but not enough is known about findings in viral illness for it to be used as a standard of practice to diagnose respiratory illness.
HYPOTHESIS: In children with lower respiratory symptoms, presence of multifocal areas of 3 or more B-lines on lung ultrasound will have high sensitivity for viral-positive ALRI, and consolidation of 1 cm or more will have high specificity for viral-positive ALRI. One or more LUS findings will emerge as highly sensitive or specific for bacterial and viral co-infection.
METHODS: This is a cross-sectional, hospital-based study of diagnostic accuracy of lung ultrasound. Study participants will include 240 children under the age of 3 years in Lima and Puno, Peru presenting to study hospitals for acute respiratory illness.
IMPACT: If this study successfully identifies lung ultrasound findings sensitive or specific for viral ALRI, this will help fill gaps in knowledge necessary for development of lung ultrasound guidelines for diagnosis of lower respiratory illness in children. Such guidelines would result in more accurate diagnosis, improved clinical care, improved antimicrobial stewardship, and ultimately reduced morbidity and mortality from respiratory illness in children.