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Colegio de Medicina Interna de México.
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2017, Number 6

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Med Int Mex 2017; 33 (6)

Diagnosis of pneumonia by ultrasound at emergency room

González-Martínez KI
Full text How to cite this article

Language: Spanish
References: 6
Page: 822-825
PDF size: 400.96 Kb.


Key words:

pneumonia, pulmonary ultrasound, pleural effusion, lines B, chest radiograph.

ABSTRACT

This paper reports the clinical case of a 54-year-old male patient, which entered to the service due to respiratory difficulty. Patient initiated his current suffering a month before the hospital admission with productive cough with purulent, abundant expectoration, not quantified fever, and loss of weight, two days before to his hospital admission respiratory difficulty was added that was exacerbated approximately 3 hours prior to income. To the physical exploration conscious patient was observed with vital signs: HR 130 bpm, RR 27 bpm, blood pressure 115/73 mmHg, temperature 36.4ºC, with shortness of breath, use of accessory muscles, tachycardia, tachypnea, with saturation to air ambience of 89%; precedents of importance: positive drug dependency; clinic data were integrated of community-acquired pneumonia, X-ray chest evidenced effacement of the costophrenic and costodiaphragmatic angle; thus, it was suspected pleural effusion; however, it was decided to perform pulmonary USG to confirm effusion vs pleural pulmonary consolidation, in which there were data compatible with low pleural effusion and right basal pulmonary consolidation area; handling was started with double antibiotic scheme. This article demonstrates that pulmonary USG turns out to be an effective and reliable tool in the early diagnosis of pneumonia in the Emergency Department, without necessity of chest X-ray, it has even much larger sensitivity for diagnosis of pleural effusion in comparison with conventional radiography.


REFERENCES

  1. Vollmer I, Gayete A. Ecografía torácica. Archivos de Bronconeumología 2010;46(1):27-34.

  2. Lichtenstein DA. Ultrasound in the management of thoracic disease. Crit Care Med 2007;35(suppl):S250-61.

  3. Yang PC, Luh KT, Chang DB, Yu CJ, Kuo SH, Wu HD. Ultrasonographic evaluation of pulmonary consolidation. Am Rev Respir Dis 1992;146:757-62.

  4. Lichtenstein DA, Peyrouset O. Is lung ultrasound superior to CT? The example of a CT occult necrotizing pneumonia. Intensive Care Med 2006;32:333-5.

  5. Fernandez-Bussy S, Labarca G, Lanza M, Folch E, Majid A. Aplicaciones torácicas del ultrasonido. Rev Med Chile 2016;144:903-909.

  6. Rincón Salas JJ. Manual de ultrasonido en terapia intensiva y emergencias. 2ª ed. México, 2016;41-57.




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Med Int Mex. 2017;33