Lung ultrasound findings in neonatal viral pneumonia: case series and literature review.

Viral pneumonia (VP) is uncommon and may be underdiagnosed in neonates due to unspecific clinical course and radiological appearance. Lung ultrasound (LUS) is a well-known technique to diagnose and manage bronchiolitis due to respiratory syncytial virus (RSV) but its role in neonates with VP caused by other viruses remains unclear due to the rarity of this condition. We report five cases of microbiologically confirmed, neonatal VP caused by viruses other than RSV along with their LUS findings. Abnormal but not specific ultrasound findings were present in all patients, and they widely varied in parallel with the clinical course. LUS findings spanned the whole spectrum of LUS semiology and reflected severity but did not identify or suggest the aetiology. These cases illustrate the LUS findings of uncommon cases of neonatal VP and highlight the need to incorporate clinical and laboratory data with lung imaging to refine the diagnosis.

conclusionNeonates with VP have a wide range of LUS appearances. LUS findings are not pathognomonic but can be usefully integrated with clinical and laboratory data. WHAT IS KNOWN: • Lung ultrasound is helpful to diagnose pneumonia in the paediatric population. However, its findings in neonates with viral pneumonia have not been formally described yet and its role to differentiate the aetiology remains unclear. WHAT IS NEW: • We report five cases of neonatal viral pneumonia describing their lung ultrasound findings. They present the whole spectrum of lung ultrasound semiology and are unspecific for the viral aetiology or the patient age. Lung ultrasound findings are consistent with the clinical severity (i.e. worse ultrasound findings were observed in patients with worse clinical course).