{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:28:49Z","timestamp":1786120129346,"version":"build-2736575974"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Traditional methods to evaluate for pediatric pneumonia include clinical examination and chest radiography (CXR). Point-of-care lung ultrasound (LUS) has emerged as a promising, noninvasive alternative for diagnosing pediatric pneumonia. This review highlights the diagnostic accuracy, benefits, and limitations of LUS compared with clinical assessment and CXR in pediatric patients with suspected pneumonia. Multiple meta-analyses demonstrate that LUS offers high sensitivity (up to 94%) and specificity (up to 96%) in diagnosing pediatric pneumonia, comparable to or exceeding CXR performance. LUS provides significant advantages, including no radiation, bedside applicability, and lower costs. However, challenges remain in standardizing LUS interpretation, particularly distinguishing bacterial pneumonia from viral illness and asthma, where overlapping ultrasound findings are common and require careful clinical correlation. Standardized protocols, clinician training, and diagnostic algorithms are essential to optimize LUS utility in pediatric respiratory care. Further research is warranted to refine differentiation between bacterial and viral etiologies and effectively integrate LUS into routine clinical pathways.<\/jats:p>","DOI":"10.1097\/pec.0000000000003533","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:02:37Z","timestamp":1777442557000},"page":"391-399","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The Use of Point-of-Care Lung Ultrasound in the Diagnosis of Pneumonia in Pediatric Patients"],"prefix":"10.1097","volume":"42","author":[{"given":"Noah","family":"Marzook","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"issue":"suppl 2","key":"R2-20260429","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1086\/511159","article-title":"Infectious Diseases Society of America\/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults","volume":"44","author":"Mandell","year":"2007","journal-title":"Clin Infect Dis"},{"key":"R3-20260429","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1056\/NEJMoa1405870","article-title":"Community-acquired pneumonia requiring hospitalization among US children","volume":"372","author":"Jain","year":"2015","journal-title":"New England Journal of Medicine"},{"key":"R4-20260429","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1093\/cid\/cir531","article-title":"The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America","volume":"53","author":"Bradley","year":"2011","journal-title":"Clin Infect Dis"},{"key":"R5-20260429","doi-asserted-by":"crossref","first-page":"e20193728","DOI":"10.1542\/peds.2019-3728","article-title":"Biomarkers and disease severity in children with community-acquired pneumonia","volume":"145","author":"Florin","year":"2020","journal-title":"Pediatrics"},{"key":"R6-20260429","doi-asserted-by":"crossref","first-page":"684628","DOI":"10.3389\/fped.2021.684628","article-title":"Diagnostic accuracy of routinely available biomarkers to predict bacteremia in children with community-acquired pneumonia: A Secondary analysis of the GPIP\/ACTIV pneumonia study in France, 2009\u20132018","volume":"9","author":"Dudognon","year":"2021","journal-title":"Front Pediatr"},{"issue":"suppl 2","key":"R7-20260429","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1136\/thoraxjnl-2011-200598","article-title":"British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011","volume":"66","author":"Harris","year":"2011","journal-title":"Thorax"},{"key":"R8-20260429","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1001\/jama.2017.9039","article-title":"Does this child have pneumonia?: the rational clinical examination systematic review","volume":"318","author":"Shah","year":"2017","journal-title":"JAMA"},{"key":"R9-20260429","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1097\/INF.0b013e3181cb45a7","article-title":"Lack of predictive value of tachypnea in the diagnosis of pneumonia in children","volume":"29","author":"Shah","year":"2010","journal-title":"Pediatr Infect Dis J"},{"key":"R10-20260429","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1177\/000992288202101205","article-title":"Clinical predictors of pneumonia as a guide to ordering chest roentgenograms","volume":"21","author":"Leventhal","year":"1982","journal-title":"Clin Pediatr (Phila)"},{"key":"R11-20260429","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1001\/jama.279.4.308","article-title":"Does this infant have pneumonia?","volume":"279","author":"Margolis","year":"1998","journal-title":"JAMA"},{"key":"R12-20260429","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1097\/PEC.0000000000003070","article-title":"Community-acquired pneumonia in children","volume":"39","author":"Rees","year":"2023","journal-title":"Pediatr Emerg Care"},{"key":"R13-20260429","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1007\/s00247-017-3944-4","article-title":"Guidelines for the use of chest radiographs in community-acquired pneumonia in children and adolescents","volume":"47","author":"Andronikou","year":"2017","journal-title":"Pediatr Radiol"},{"key":"R14-20260429","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1378\/chest.07-2800","article-title":"Relevance of lung ultrasound in the diagnosis of acute respiratory failure*: the BLUE protocol","volume":"134","author":"Lichtenstein","year":"2008","journal-title":"Chest"},{"key":"R15-20260429","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.chest.2016.02.643","article-title":"Feasibility and safety of substituting lung ultrasonography for chest radiography when diagnosing pneumonia in children","volume":"150","author":"Jones","year":"2016","journal-title":"Chest"},{"key":"R16-20260429","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1542\/peds.2014-2833","article-title":"Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis","volume":"135","author":"Pereda","year":"2015","journal-title":"Pediatrics"},{"key":"R17-20260429","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1002\/ppul.24020","article-title":"Lung ultrasound compared to chest X-ray for diagnosis of pediatric pneumonia: a meta-analysis","volume":"53","author":"Balk","year":"2018","journal-title":"Pediatr Pulmonol"},{"key":"R18-20260429","doi-asserted-by":"crossref","first-page":"3130","DOI":"10.1002\/ppul.27221","article-title":"Systematic review and meta-analysis of the accuracy of lung ultrasound and chest radiography in diagnosing community acquired pneumonia in children","volume":"59","author":"Shi","year":"2024","journal-title":"Pediatr Pulmonol"},{"key":"R19-20260429","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s00134-012-2513-4","article-title":"International evidence-based recommendations for point-of-care lung ultrasound","volume":"38","author":"Volpicelli","year":"2012","journal-title":"Intensive Care Med"},{"key":"R20-20260429","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.emc.2024.05.002","article-title":"Ultrasound physics","volume":"42","author":"Shokoohi","year":"2024","journal-title":"Emerg Med Clin"},{"key":"R21-20260429","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/s11547-008-0247-8","article-title":"Ultrasound diagnosis of pneumonia in children","volume":"113","author":"Copetti","year":"2008","journal-title":"Radiol Med (Torino)"},{"key":"R22-20260429","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1002\/jum.15284","article-title":"Is there a role for lung ultrasound during the COVID-19 pandemic?","volume":"39","author":"Soldati","year":"2020","journal-title":"J Ultrasound Med"},{"key":"R23-20260429","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-020-2787-9","article-title":"International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)","volume":"24","author":"Singh","year":"2020","journal-title":"Crit Care"},{"key":"R24-20260429","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1097\/ALN.0000000000003757","article-title":"Quantitative lung ultrasound: technical aspects and clinical applications","volume":"134","author":"Mongodi","year":"2021","journal-title":"Anesthesiology"},{"key":"R25-20260429","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1097\/ALN.0000000000003096","article-title":"Lung ultrasound in emergency and critically ill patients: number of supervised exams to reach basic competence","volume":"132","author":"Arbelot","year":"2020","journal-title":"Anesthesiology"},{"key":"R26-20260429","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1111\/acem.13818","article-title":"Diagnostic accuracy of lung ultrasound performed by novice versus advanced sonographers for pneumonia in children: a systematic review and meta-analysis","volume":"26","author":"Tsou","year":"2019","journal-title":"Acad Emerg Med"},{"key":"R27-20260429","doi-asserted-by":"crossref","first-page":"203","DOI":"10.3390\/arm91030017","article-title":"Lung ultrasound in critical care and emergency medicine: clinical review","volume":"91","author":"Rocca","year":"2023","journal-title":"Advances Respir Med"},{"key":"R28-20260429","doi-asserted-by":"crossref","first-page":"e225","DOI":"10.15557\/JoU.2021.0036","article-title":"Signs and lines in lung ultrasound","volume":"21","author":"Bhoil","year":"2021","journal-title":"J Ultrason"},{"key":"R29-20260429","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1164\/rccm.201802-0236CI","article-title":"Lung ultrasound for critically ill patients","volume":"199","author":"Mojoli","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"R30-20260429","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/cc11201","article-title":"Early recognition of the 2009 pandemic influenza A (H1N1) pneumonia by chest ultrasound","volume":"16","author":"Testa","year":"2012","journal-title":"Crit Care"},{"key":"R31-20260429","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2036-7902-4-16","article-title":"Prospective application of clinician-performed lung ultrasonography during the 2009 H1N1 influenza A pandemic: distinguishing viral from bacterial pneumonia","volume":"4","author":"Tsung","year":"2012","journal-title":"Crit Ultrasound J"},{"key":"R32-20260429","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1007\/s00134-003-2075-6","article-title":"Ultrasound diagnosis of alveolar consolidation in the critically ill","volume":"30","author":"Lichtenstein","year":"2004","journal-title":"Intensive Care Med"},{"key":"R33-20260429","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1001\/2013.jamapediatrics.107","article-title":"Prospective evaluation of point-of-care ultrasonography for the diagnosis of pneumonia in children and young adults","volume":"167","author":"Shah","year":"2013","journal-title":"JAMA Pediatr"},{"key":"R34-20260429","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jpeds.2021.12.052","article-title":"Significance of sonographic subcentimeter, subpleural consolidations in pediatric patients evaluated for pneumonia","volume":"243","author":"Gravel","year":"2022","journal-title":"J Pediatr"},{"key":"R35-20260429","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1002\/jcu.22951","article-title":"Can lung ultrasound differentiate between bacterial and viral pneumonia in children?","volume":"49","author":"Malla","year":"2021","journal-title":"J of Clinical Ultrasound"},{"key":"R36-20260429","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1002\/ppul.25156","article-title":"Lung ultrasound in bronchiolitis","volume":"56","author":"La Regina","year":"2021","journal-title":"Pediatr Pulmonol"},{"key":"R37-20260429","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1136\/emermed-2015-205302","article-title":"Point-of-care lung ultrasound in young children with respiratory tract infections and wheeze","volume":"33","author":"Varshney","year":"2016","journal-title":"Emerg Med J"},{"key":"R38-20260429","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1378\/chest.08-2281","article-title":"The dynamic air bronchogram","volume":"135","author":"Lichtenstein","year":"2009","journal-title":"Chest"},{"key":"R39-20260429","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1136\/thorax.57.5.438","article-title":"Differentiation of bacterial and viral pneumonia in children","volume":"57","author":"Virkki","year":"2002","journal-title":"Thorax"},{"key":"R40-20260429","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12890-018-0750-1","article-title":"Lung ultrasound for the diagnosis of pneumonia in children with acute bronchiolitis","volume":"18","author":"Biagi","year":"2018","journal-title":"BMC Pulm Med"},{"key":"R41-20260429","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1370\/afm.2796","article-title":"Lung ultrasound performed by primary care physicians for clinically suspected community-acquired pneumonia: a multicenter prospective study","volume":"20","author":"Rodr\u00edguez-Contreras","year":"2022","journal-title":"Ann Fam Med"},{"key":"R42-20260429","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.ajem.2016.12.057","article-title":"Point of care lung ultrasound of children with acute asthma exacerbations in the pediatric ED","volume":"35","author":"Dankoff","year":"2017","journal-title":"Am J Emerg Med"},{"key":"R43-20260429","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1002\/jum.16617","article-title":"Lung ultrasound findings in children with asthma exacerbations","volume":"44","author":"Hoffmann","year":"2025","journal-title":"J Ultrasound Med"},{"key":"R44-20260429","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1002\/ppul.25907","article-title":"Characterizing pediatric lung ultrasound findings during a chemically induced bronchospasm","volume":"57","author":"Gagnon","year":"2022","journal-title":"Pediatr Pulmonol"},{"key":"R45-20260429","doi-asserted-by":"crossref","first-page":"2474","DOI":"10.1002\/ppul.26061","article-title":"Lung ultrasound findings in asymptomatic healthy children with asthma","volume":"57","author":"Marzook","year":"2022","journal-title":"Pediatr Pulmonol"},{"key":"R46-20260429","doi-asserted-by":"crossref","first-page":"935","DOI":"10.3390\/diagnostics10110935","article-title":"Consensus on the application of lung ultrasound in pneumonia and bronchiolitis in children","volume":"10","author":"Jaworska","year":"2020","journal-title":"Diagnostics"},{"key":"R47-20260429","doi-asserted-by":"crossref","first-page":"172","DOI":"10.3390\/diagnostics9040172","article-title":"Acute bronchiolitis: is there a role for lung ultrasound?","volume":"9","author":"Di Mauro","year":"2019","journal-title":"Diagnostics"},{"key":"R48-20260429","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s00431-019-03335-6","article-title":"Point-of-care lung ultrasound in infants with bronchiolitis in the pediatric emergency department: a prospective study","volume":"178","author":"Supino","year":"2019","journal-title":"Eur J Pediatr"},{"key":"R49-20260429","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1002\/ppul.24287","article-title":"Lung ultrasound for prediction of respiratory support in infants with acute bronchiolitis: a cohort study","volume":"54","author":"Bueno-Campa\u00f1a","year":"2019","journal-title":"Pediatr Pulmonol"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/PEC.0000000000003533","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T20:15:20Z","timestamp":1786047320000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/PEC.0000000000003533"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,29]]},"references-count":48,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003533","relation":{},"ISSN":["0749-5161","1535-1815"],"issn-type":[{"value":"0749-5161","type":"print"},{"value":"1535-1815","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,29]]},"assertion":[{"value":"2025-06-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}