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Pleuro-pulmonary ultrasound in the diagnosis and follow-up of lung infections in children with cancer: a pilot sudy
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  • Mariaclaudia Meli,
  • Milena La Spina,
  • Gian Luca Trobia,
  • Luca Lo Nigro,
  • Giovanna Russo,
  • Andrea Di Cataldo
Mariaclaudia Meli
University of Catania School of Medicine
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Milena La Spina
University of Catania School of Medicine
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Gian Luca Trobia
Azienda Ospedaliera Cannizzaro
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Luca Lo Nigro
University of Catania School of Medicine
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Giovanna Russo
University of Catania
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Andrea Di Cataldo
University of Catania
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Abstract

Febrile neutropenia and lung infections are common and potential fatal complications of pediatric cancer patients during chemotherapy. Lung ultrasound (LUS) has a good accurancy in the diagnosis of pneumonia in childhood. To our knowledge there are no studies concerning its utilization in the diagnosis and follow-up of pulmonary infection in children with cancer. The goal of this pilot study is to determine the accuracy of lung ultrasonography for the diagnosis and follow up of pneumonia in children and adolescents with cancer during fever. This is a prospective observational case-control monocentric study conducted in the Pediatric Hematology and Oncology Department of University Hospital of Catania in patients aged<18 years with cancer, with or without fever. Attending Physician used ultrasonography to diagnose pneumonia in children with cancer during fever. Non infected cancer patients were also tested with LUS to evaluate its accuracy. When performed, the results of chest X-ray and chest CT scan were compared with LUS results. Thirty-eight patients were studied. All underwent LUS, 16 underwent CXR, 3 chest CT. Statistical analysis showed LUS specificity of 95%, and sensitivity of 100%; CXR, instead showed a specificity of 80% and a sensitivity of 50%. The positive predictive value of LUS was 90% while that of CXR was 50%. The negative predictive value of LUS was 100% while that of CXR was 80%.This study shows for the first time that LUS allows physicians to diagnose pneumonia in children and young adults with cancer, with high specificity and sensitivity.

Peer review status:UNDER REVIEW

02 Jun 2021Submitted to Pediatric Pulmonology
02 Jun 2021Assigned to Editor
02 Jun 2021Submission Checks Completed
04 Jun 2021Reviewer(s) Assigned
19 Jun 2021Review(s) Completed, Editorial Evaluation Pending