Construction of differential diagnosis model of viral pneumonia and bacterial pneumonia based on lung ultrasonography characteristics_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WANG Jing ,  LI Zhuanping , LI Yanting

Department of Ultrasound Medicine, South Hospital of Tongchuan People’s Hospital, Tongchuan, Shanxi 727031, P. R. China;

Corresponding?author：

LI Zhuanping, Email: 731082638@qq.com

Keywords：

Viral pneumonia; bacterial pneumonia; pulmonary ultrasound; differential diagnosis; model

DOI：

10.7507/1671-6205.202407097

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To construct the differential diagnosis model of viral pneumonia and bacterial pneumonia based on lung ultrasonography (LUS) characteristics. Methods A total of 248 patients with pneumonia who completed LUS in our hospital from January 2021 to March 2024 were retrospectively included, and were divided into a viral group (140 cases) and a bacterial group (108 cases) according to the final etiological diagnosis. Predictors in differential diagnosis between viral pneumonia and bacterial pneumonia were analyzed by univariate and multivariate methods. The differential diagnosis model of viral pneumonia and bacterial pneumonia and the prediction efficiency were evaluated. Results Univariate and multivariate logistic analysis showed that the presence or absence of lung consolidation, pleural effusion, B-line range of both lungs and pulmonary ultrasound score were independent predictors of the differential diagnosis of viral pneumonia and bacterial pneumonia (P<0.05). Using the logistic regression model of lung consolidation, pleural effusion, bilateral B-line range, and pulmonary ultrasound score, including the P-values of three variables (lung consolidation, pleural effusion, and bilateral B-line range), and the P-values of four variables (lung consolidation, pleural effusion, bilateral B-line range, and pulmonary ultrasound score), the receiver operating characteristic curve was used to predict the diagnosis of patient. The areas under the curve were 0.863, 0.612, 0.669, 0.684, 0.904, and 0.920, respectively. Conclusion Lung consolidation, pleural effusion, B-line range of both lungs and pulmonary ultrasound score detected by LUS have good diagnostic efficacy in the differential diagnosis of viral pneumonia and bacterial pneumonia, suggesting that LUS technology may be used in the differential diagnosis of viral pneumonia and bacterial pneumonia.

Citation： WANG Jing, LI Zhuanping, LI Yanting. Construction of differential diagnosis model of viral pneumonia and bacterial pneumonia based on lung ultrasonography characteristics. Chinese Journal of Respiratory and Critical Care Medicine, 2025, 24(5): 313-318. doi: 10.7507/1671-6205.202407097 Copy

1.	C?mert RG, Cing?z E, Me?e S, et al. Radiological findings in SARS-CoV-2 viral pneumonia compared to other viral pneumonias: a single-centre study. Can J Infect Dis Med Microbiol, 2022, 29(9): 2826-2824.
2.	劉元琳, 趙浩天, 劉奕, 等. 肺超聲與胸部CT評價社區獲得性肺炎的一致性研究. 中國超聲醫學雜志, 2022, 38(8): 841-844.
3.	Geanacopoulos AT, Lipsett SC, Hirsch AW, et al. Impact of viral radiographic features on antibiotic treatment for pediatric pneumonia. J Pediatric Infect Dis Soc, 2022, 11(5): 207-213.
4.	Mearelli F, Casarsa C, Trapani A, et al. Lung ultrasound may support internal medicine physicians in predicting the diagnosis, bacterial etiology and favorable outcome of community-acquired pneumonia. Sci Rep, 2021, 11(1): 17016-17024.
5.	譚國良, 連細華, 張穎, 等. 新型冠狀病毒肺炎經胸超聲和CT評估相關性的研究. 中國超聲醫學雜志, 2020, 36(6): 507-510.
6.	Buonsenso D, Brancato F, Valentini P, et al. The use of lung ultrasound to monitor the antibiotic response of community-acquired pneumonia in children: a preliminary hypothesis. J Ultrasound Med, 2020, 39(4): 817-826.
7.	Linsalata G, Okoye C, Antognoli R, et al. Pneumonia lung ultrasound score (PLUS): a new tool for detecting pneumonia in the oldest patients. J Am Geriatr Soc, 2020, 68(12): 2855-2862.
8.	Buz Ya?ar A, Tarhan M, Atalay B, et al. Investigation of childhood pneumonia with thoracic ultrasound: a comparison between X-ray and ultrasound. Ultrasound Q, 2023, 39(4): 216-222.
9.	Ma HR, Deng BY, Liu J, et al. Lung ultrasound to diagnose infectious pneumonia of newborns: a prospective multicenter study. Pediatr Pulmonol, 2023, 58(1): 122-129.
10.	Ciuca IM, Dediu M, Pop LL. Pediatric pneumonia (PedPne) lung ultrasound score and inflammatory markers: a pilot study. Pediatr Pulmonol, 2022, 57(2): 576-582.
11.	Sultan SR. Association between lung ultrasound patterns and pneumonia. Ultrasound Q, 2022, 38(3): 246-249.
12.	Haaksma ME, Smit JM, Heldeweg MLA, et al. Extended lung ultrasound to differentiate between pneumonia and atelectasis in critically ill patients: a diagnostic accuracy study. Crit Care Med, 2022, 50(5): 750-759.
13.	Elabbas A, Choudhary R, Gullapalli D, et al. Lung ultrasonography beyond the diagnosis of pediatrics pneumonia. Cureus, 2022, 14(2): e22460.
14.	Pérez Pallarés J, Lerenas Bernal F, Cabello Jabalquinto MR, et al. Usefulness of thoracic ultrasound for diagnosis and follow-up of pneumonia. Rev Esp Quimioter, 2022, 35(Suppl 1): 21-24.
15.	Kharasch S, Duggan NM, Cohen AR, et al. Lung ultrasound in children with respiratory tract infections: viral, bacterial or COVID-19? A narrative review. Open Access Emerg Med, 2020, 12(10): 275-285.
16.	Tung-Chen Y, Giraldo Hernández A, Mora Vargas A, et al. Impact of lung ultrasound during the SARS-CoV-2 pandemic: distinction between viral and bacterial pneumonia. Reumatol Clin (Engl Ed), 2022, 18(9): 546-550.
17.	Omran A, Awad H, Ibrahim M, et al. Lung ultrasound and neutrophil lymphocyte ratio in early diagnosis and differentiation between viral and bacterial pneumonia in young children. Children (Basel), 2022, 9(10): 1457-1464.
18.	Stoicescu ER, Iacob R, Ilie AC, et al. Differentiating viral from bacterial pneumonia in children: the diagnostic role of lung ultrasound-a prospective observational study. Diagnostics (Basel), 2024, 14(5): 480-487.
19.	趙浩天, 李麗, 趙鶴齡, 等. 心肺超聲在成人急性呼吸困難中的應用: 心源性肺水腫與肺炎的鑒別診斷模型構建. 中華超聲影像學雜志, 2023, 32(3): 242-249.

1. C?mert RG, Cing?z E, Me?e S, et al. Radiological findings in SARS-CoV-2 viral pneumonia compared to other viral pneumonias: a single-centre study. Can J Infect Dis Med Microbiol, 2022, 29(9): 2826-2824.
2. 劉元琳, 趙浩天, 劉奕, 等. 肺超聲與胸部CT評價社區獲得性肺炎的一致性研究. 中國超聲醫學雜志, 2022, 38(8): 841-844.
3. Geanacopoulos AT, Lipsett SC, Hirsch AW, et al. Impact of viral radiographic features on antibiotic treatment for pediatric pneumonia. J Pediatric Infect Dis Soc, 2022, 11(5): 207-213.
4. Mearelli F, Casarsa C, Trapani A, et al. Lung ultrasound may support internal medicine physicians in predicting the diagnosis, bacterial etiology and favorable outcome of community-acquired pneumonia. Sci Rep, 2021, 11(1): 17016-17024.
5. 譚國良, 連細華, 張穎, 等. 新型冠狀病毒肺炎經胸超聲和CT評估相關性的研究. 中國超聲醫學雜志, 2020, 36(6): 507-510.
6. Buonsenso D, Brancato F, Valentini P, et al. The use of lung ultrasound to monitor the antibiotic response of community-acquired pneumonia in children: a preliminary hypothesis. J Ultrasound Med, 2020, 39(4): 817-826.
7. Linsalata G, Okoye C, Antognoli R, et al. Pneumonia lung ultrasound score (PLUS): a new tool for detecting pneumonia in the oldest patients. J Am Geriatr Soc, 2020, 68(12): 2855-2862.
8. Buz Ya?ar A, Tarhan M, Atalay B, et al. Investigation of childhood pneumonia with thoracic ultrasound: a comparison between X-ray and ultrasound. Ultrasound Q, 2023, 39(4): 216-222.
9. Ma HR, Deng BY, Liu J, et al. Lung ultrasound to diagnose infectious pneumonia of newborns: a prospective multicenter study. Pediatr Pulmonol, 2023, 58(1): 122-129.
10. Ciuca IM, Dediu M, Pop LL. Pediatric pneumonia (PedPne) lung ultrasound score and inflammatory markers: a pilot study. Pediatr Pulmonol, 2022, 57(2): 576-582.
11. Sultan SR. Association between lung ultrasound patterns and pneumonia. Ultrasound Q, 2022, 38(3): 246-249.
12. Haaksma ME, Smit JM, Heldeweg MLA, et al. Extended lung ultrasound to differentiate between pneumonia and atelectasis in critically ill patients: a diagnostic accuracy study. Crit Care Med, 2022, 50(5): 750-759.
13. Elabbas A, Choudhary R, Gullapalli D, et al. Lung ultrasonography beyond the diagnosis of pediatrics pneumonia. Cureus, 2022, 14(2): e22460.
14. Pérez Pallarés J, Lerenas Bernal F, Cabello Jabalquinto MR, et al. Usefulness of thoracic ultrasound for diagnosis and follow-up of pneumonia. Rev Esp Quimioter, 2022, 35(Suppl 1): 21-24.
15. Kharasch S, Duggan NM, Cohen AR, et al. Lung ultrasound in children with respiratory tract infections: viral, bacterial or COVID-19? A narrative review. Open Access Emerg Med, 2020, 12(10): 275-285.
16. Tung-Chen Y, Giraldo Hernández A, Mora Vargas A, et al. Impact of lung ultrasound during the SARS-CoV-2 pandemic: distinction between viral and bacterial pneumonia. Reumatol Clin (Engl Ed), 2022, 18(9): 546-550.
17. Omran A, Awad H, Ibrahim M, et al. Lung ultrasound and neutrophil lymphocyte ratio in early diagnosis and differentiation between viral and bacterial pneumonia in young children. Children (Basel), 2022, 9(10): 1457-1464.
18. Stoicescu ER, Iacob R, Ilie AC, et al. Differentiating viral from bacterial pneumonia in children: the diagnostic role of lung ultrasound-a prospective observational study. Diagnostics (Basel), 2024, 14(5): 480-487.
19. 趙浩天, 李麗, 趙鶴齡, 等. 心肺超聲在成人急性呼吸困難中的應用: 心源性肺水腫與肺炎的鑒別診斷模型構建. 中華超聲影像學雜志, 2023, 32(3): 242-249.

Chinese Journal of Respiratory and Critical Care Medicine

Construction of differential diagnosis model of viral pneumonia and bacterial pneumonia based on lung ultrasonography characteristics

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content