Comparison of Lung Ultrasound Findings in Patients with Pulmonary Tuberculosis and Lobar Pneumonia: A Case-control Study.

Abstract

Background: The utility of lung ultrasound (LUS) in diagnosing respiratory disorders is being studied only in recent times. We aimed to describe the ultrasound (USG) features of pulmonary tuberculosis (TB) and compare them with those of lobar pneumonia. In addition, the LUS findings of both diseases were corroborated with chest X-ray findings.

Methods: The study subjects consisted of adult subjects recently diagnosed with pulmonary TB and those diagnosed with lobar pneumonia. Both subsets of patients underwent LUS evaluation.

Results: Ninety-six subjects with 64 microbiologically confirmed TB and 32 lobar pneumonia patients were included. The study subjects' mean age was 46.78 ± 15.75 years and the majority were males (n = 62; 64.6%). LUS showed focal interstitial pattern, cavity, and irregular pleura in TB patients which were significantly different (P ≤ 0.001) from the findings of air bronchogram and/or shred sign seen in patients with lobar pneumonia. The overall sensitivity of LUS compared to X-ray, to identify abnormalities in TB and lobar pneumonia patients, was 88.6%. The LUS and CXR findings were concordant in 93.75% of TB patients and 90.6%) of lobar pneumonia patients. Additional USG abnormalities other than that seen on CXR were demonstrated in 13 (20.3%) TB patients.

Conclusion: LUS is a valuable tool to detect TB and lobar pneumonia and can discriminate between the two conditions. LUS performance was on par with CXR in the detection of abnormalities. The lack of radiation exposure and portability of LUS makes it an attractive tool for bedside use as well as in field conditions where radiography may not be readily available.