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ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Pulmonology
Volume 12 - 2024 |
doi: 10.3389/fped.2024.1411365
Distinguishing Types and Severity of Pediatric Pneumonia Using Modified Lung Ultrasound Score
Provisionally accepted- 1 Quanzhou Maternal and Child Health Hospital, Quanzhou, China
- 2 Quanzhou Medical College, Quanzhou, Fujian Province, China
- 3 The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China
Objective: This study aimed to investigate the diagnostic utility of the modified lung ultrasound score (MLUS) in distinguishing between Mycoplasma pneumonia and viral pneumonia in children and evaluate their severity.Methods: A prospective collection of 137 suspected cases of community-acquired pneumonia in children admitted to the Quanzhou Maternity and Children's Hospital in Quanzhou City, Fujian Province, from January 2023 to December 2023 constituted the study cohort. All patients underwent lung ultrasound examinations, and MLUS scores were assigned based on ultrasound findings, including pleural lines, A-lines, B-lines, and lung consolidations. Based on the pathogenic results, the patients were categorized into the Mycoplasma pneumonia (74 cases) and viral pneumonia (63 cases) groups. The severity was classified as mild (110 cases) or severe (27 cases). The diagnostic value of MLUS for Mycoplasma pneumonia and viral pneumonia in children was analyzed. Results: (1) MLUS scores were significantly different between the Mycoplasma pneumonia (15, 10–21) and viral pneumonia (8, 5–16) groups (P =0.002). ROC curve analysis indicated that using a cut-off value of 11, MLUS exhibited a sensitivity of 70.3%, specificity of 58.7%, and an area under curve (AUC) of 0.653 for diagnosing Mycoplasma pneumonia. Furthermore, large-area lung consolidation on ultrasound images demonstrated good diagnostic performance for predicting Mycoplasma pneumonia, with an AUC of 0.763, a sensitivity of 71.6%, and a specificity of 81.0%. (2) MLUS scores were significantly different between the mild pneumonia (10.5, 5–17) and severe pneumonia (21, 16–29) groups (P < 0.001). ROC curve analysis using a cut-off value of 16 showed a sensitivity of 77.8%, specificity of 73.6%, and AUC of 0.818 for diagnosing severe pneumonia.Multivariate regression analysis revealed that both MLUS and white blood cell count were independent factors influencing the severity. The constructed nomogram model demonstrated robust stability with a sensitivity of 85.2%, a specificity of 74.5%, and an AUC of 0.858 for predicting severe childhood pneumonia. Conclusion: MLUS, coupled with ultrasound signs of large-area lung consolidation, had reference significance for the differential diagnosis of Mycoplasma pneumonia and viral pneumonia in children and can be a preliminary assessment of the severity of viral pneumonia or mycoplasma pneumonia in children.
Keywords: Wen Xie: Investigation, Writing -original draft, Writing -review & editing. Jingyang Zheng: Resources, supervision, Writingreview & editing. Qiuxia Jiang: Data curation, Writing -review & editing. Guorong Ly u: Methodology, Writingreview & editing. Wei-ru Lin: Resources, Writing -review & editing. Junxian Ruan: Data curation
Received: 02 Apr 2024; Accepted: 24 Jul 2024.
Copyright: © 2024 Xie, Ruan, Jiang, Zheng, Lin and Lyu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Junxian Ruan, Quanzhou Maternal and Child Health Hospital, Quanzhou, China
Qiuxia Jiang, Quanzhou Maternal and Child Health Hospital, Quanzhou, China
Guorong Lyu, Quanzhou Medical College, Quanzhou, 362100, Fujian Province, China
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