, Volume 32, Issue 2, pp 334-335

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

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Although not expected to perfectly assess lung status [1], ultrasound enables access to several diagnoses, such as pleural effusion, alveolar consolidation, interstitial syndrome or pneumothorax [2]. For the diagnosis of alveolar consolidation, sensitivity of ultrasound is 90% and specificity 98% [3]. Clinical experience suggests that ultrasound has on occasion superior focal resolution to CT. This is somewhat acknowledged for septations within pleural effusions, which are usually not depicted using CT. Among numerous cases we routinely observe, here is a blatant one.

Case report

A 75-year-old man was admitted in our ICU for acute respiratory failure with pneumonia. He was promptly intubated and received amoxicillin, clavulanic acid and ofloxacin. A routine chest ultrasound (Hitachi Sumi 405, Hitachi Medical, Tokyo, Japan; and 3.5 MHz micro-convex probe) was performed on the second day. Within a left lower-lobe alveolar consolidation, several round-shaped hypoechoic areas were detected (