Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnosis.
- X-ray of the thorax (X-ray thorax/chest), in two planes – especially in cases of differential diagnostic ambiguity, severe disease or concomitant diseases (risk factors) [evidence of a pulmonary infiltrate; the surest radiological sign of an infiltrate is the air bronchogram, it is also called a positive “air bronchogram”; this is due to the fact that in this area air-filled bronchi stand out from the surrounding area]
- Lung sonography (synonyms: lung ultrasound; English Lung ultrasonography (LUS)) – for suspected pneumonia (pneumonia) in children (as an alternative to X-ray chest).
- Pulse oximetry (method for non-invasive determination of arterial oxygen saturation via measurement of light absorption) [severity of hypoxia/oxygen deficiency].
- Spirometry (basic examination in the context of pulmonary function diagnostics).
- Pleurasonography (ultrasound examination of the pleura (pleura) and pleural space) – if pleural effusion is suspected.
- Bronchoscopy (bronchoscopy) with bronchoalveolar lavage (BAL; method of obtaining samples used in bronchoscopy (bronchoscopy)), possibly lung biopsy (taking a sample of lung tissue).
- Computed tomography or magnetic resonance imaging of the thorax/chest (thoracic CT; thoracic MRI) – in complicating courses.
Further notes
- The negative predictive value (NPV) of a chest radiograph in children with suspected pneumonia is high. In one study, pneumonia was detected in only five of 411 children with negative radiographic findings and no antibiotic therapy in the subsequent two weeks (= NPV of radiographic findings was 98.8%).
