Introduction with a case
Introduction to pneumonia typology: Can POCUS revitalize pathology?
“Chest radiology is usually enough to confirm the diagnosis of community acquired pneumonia, whereas computed tomography is required to suggest specific pathogens.”
– Nambu et al. 2014
 Lobar Pneumonia
 Interstitial pneumonia
Clinical significance of ultrasonographic lobar pneumonia?
“Streptococcus pneumoniae… is responsible for almost all cases of lobar pneumonia and for most cases of bronchopneumonia”
– Corrin B and Nicholson AG, Pathology of the Lungs 3rd edition 2011
Lack of evidence
“Infectious lung injuries may have typical patterns. Studies are coming. Pneumonia due to Streptococcus pneumoniae often yields massive consolidation with dynamic air bronchogram, abolished lung sliding, and absence of pleural effusion.”
– Lichtenstein DA, 2010
Implications for treatment
- The presence of extensive consolidation with dynamic air bronchograms on ultrasound may correlate with a lobar pneumonia pattern.
- Lobar community acquired pneumonia is most often due to Streptococcus Pneumoniae, with some cases also due to Legionella and Klebsiella Pneumoniae.
- Treatment decisions should be based on standard approaches utilizing epidemiology and disease severity. However, for cases that fall on the borderline between different treatment regimens, the ultrasonographic pattern can occasionally provide a clue as to the etiology.
Latest posts by Josh Farkas (see all)
- PulmCrit Wee – Prophylactic antibiotics after cardiac arrest? - November 9, 2019
- IBCC chapter & cast – Acalculous cholecystitis - November 7, 2019
- PulmCrit – Correlation confounded by timing:One reason we believe bad therapies are awesome - November 4, 2019