Tiny Airways, Big Clues: Lung Ultrasound for Predicting Severity in Pediatric Pneumonia

Sofia Marchetti¹, Hugo Moreau², Emily Clarke³

Abstract

Background: Chest radiography remains the diagnostic standard for pneumonia, but it exposes children to radiation and may miss subtle early consolidation. Lung ultrasound (LUS) is radiation-free, portable, and highly sensitive.

Objective: To evaluate the diagnostic and prognostic utility of LUS in predicting pneumonia severity in children.

Methods: A prospective study of 412 children aged 2 months to 12 years was conducted between 2022 and 2024. LUS findings were compared with clinical severity scoring and chest radiography. Pleural line irregularities, subpleural consolidations, and B-line patterns were quantified.

Results: LUS identified pneumonia in 89% of cases confirmed by X-ray and 11% missed by radiography. Consolidation size >1.5 cm and bilateral B-lines were strongly associated with severe disease (p < 0.001). LUS severity score ≥ 8 predicted oxygen therapy requirement with AUC 0.90. Severe cases had mean hospital stay of 6.8 ± 2.5 days compared to 3.1 ± 1.2 days in mild pneumonia (p < 0.001).

Conclusion: LUS is a reliable, safe, and highly sensitive tool for diagnosing and grading pediatric pneumonia. It can reduce reliance on radiography and guide early treatment.