Is lung ultrasound superior to CT? The example of a CT occult necrotizing pneumonia.

摘要

Although not expected to perfectly assess lung status , ultrasound enables access to several diagnoses, such as pleural effusion, alveolar consolidation, interstitial syndrome or pneumothorax . For the diagnosis of alveolar consolidation, sensitivity of ultrasound is 90% and specificity 98% . Clinical experience suggests that ultrasound has on occasion superior focal resolution to CT. This is somewhat acknowledged for septa-tions within pleural effusions, which are usually not depicted using CT. Among numerous cases we routinely observe, here is a blatant one.failure. CT did not confirm ultrasound findings (Fig. 2). Blood and sample tests (hemocultures, telescopic catheter, etc.) failed to find the microorganism. On the seventh day, the clinical course worsened, with fever and increase in white cell count. The ultrasound findings wereroughly unchanged. A subsequent CT, performed on the eighth day with iodine injection, confirmed multiple necrotizing areas (Fig. 3). The an-tibiotherapy included rovamycin and metronidazole. The patient eventually recovered, leaving the ICU on the 20th day.