ABC
La radiografia del torace nella broncopolmonite: inutile nella maggioranza dei casi?
Chest X-ray in bronchial pneumonia: is it useless in most cases?
Carlotta Farneti, Giuseppe Vieni, Federico Marchetti
UOC di Pediatria e Neonatologia, Ospedale di Ravenna, AUSL della Romagna
Febbraio 2018 - pagg. 93 -95
Abstract
The review of the literature and of the international guidelines about the usefulness of
performing chest radiography for the diagnosis of bronchial pneumonia shows that this
examination should be limited to selected cases. If symptoms are suggestive of bronchial
pneumonia in clinically not severe children older than 2 years, the radiography should
not be performed because it does not modify the therapeutic behaviours, it does not give
accurate information about etiology, and it can give false negative or false positive
results. In this context chest radiography does not offer advantages, does not modify clinical
outcomes, could be misleading and could induce therapeutic mistakes. On the
other hand, chest radiography is strictly indicated in selected cases such as the presence
of severe respiratory symptoms, symptoms that do not improve with antibiotic therapy
within 24-48 hours, suspected tuberculosis, respiratory distress from suspected non-infectious
etiology, and highly feverish children without identified cause. Chest radiological
controls during or after therapy should be limited to selected cases and never performed
in patients responsive to therapy and clinically healed.
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Classificazione MeSH
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Bibliografia
1. Bowen SJ, Thomson AH. British Thoracic
society Paediatric Pneumonia Audit: a review
of 3 years of data. Thorax 2013;68:682-3.
2. Harris M, Clark J, Coote N, et al. British
Thoracic Society guidelines for the management
of community acquired pneumonia in
children: update 2011. Thorax 2011;66:ii1-23.
3. Bradley JS, Byington CL, Shah SS, et al.
The management of community-acquired
pneumonia in infants children older than 3
months of age: clinical practice guidelines by
the Pediatric Infectious Diseases Society and
the Infectious Diseases Society of America.
Clin Infect Dis 2011;53:e25-e7.
4. Elemraid MA, Muller M, Spencer DA, et
al. Accuracy of the interpretation of chest radiographs
for the diagnosis of paediatric
pneumonia. PLoS One 2014;9(8):e106051.
5. Zar HJ, Barnett W, Stadler A, et al. Aetiology
of childhood pneumonia in a well vaccinated
South African birth cohort: a nested case-control
study of the Drakenstein child health
study. Lancet Respir Med 2016;4:463-72.
6. Longo G, Maschio M, Panontin E, Marchetti
F, Furcolo G, Quarantiello F. La gestione
dell’accesso acuto asmatico acuto in
Pronto Soccorso (e non solo). Medico e
Bambino 2014;33:563-9.
7. Swingler GH, Hussey GD, Zwarenstein M.
Randomised controlled trial of clinical outcome
after chest radiograph in ambulatory acute
lower-respiratory infection in children.
Lancet 1998;351(9100):404-8.
8. Cao AM, Choy JP, Mohanakrishnan LN,
Bain RF, van Driel ML. Chest radiographs
for acute lower respiratory tract infections.
Cochrane Database Syst Rev 2013;(12):
CD009119.
9. De Seta L, Pannuti F, De Seta F. La polmonite
in età evolutiva. Quaderni acp 2013;20
(3):100-8.
10. McCrossan P, McNaughten B, Shields
M, Thompson A. Is follow up chest X-ray required
in children with round pneumonia?
Arch Dis Child 2017;102(12):1182-3.
11. Ventura A. La Pagina Gialla. Rx torace:
no grazie. Medico e Bambino 2017;36:621-2.
12. Boschi G, Marchetti F, Mercuri B, La
Gamba G. La broncopolmonite. Medico e
Bambino 1999;18(4):236-41.
13. Milocco C, Ronfani L, Faraguna D. La gestione
della broncopolmonite nel Friuli Venezia
Giulia. Medico e Bambino 2008;27:244-50.
14. Revised WHO classification and treatment
of childhood pneumonia at health facilities
- Evidence Summaries. World Health Organization
2014. http://apps.who.int/iris/
bitstream/10665/137319/1/9789241507813_
eng.pdf
15. Marchetti F. Le nuove linee guida sulla
polmonite di comunità: evidenze a sostegno
di una ulteriore essenzialità diagnostica e terapeutica.
Medico e Bambino 2011;30(10):
619-21.
Corrispondenza: federico.marchetti@auslromagna.it