Imaging of Chest Infections in Children

■ Imaging studies have limited value in the differentiation between viral and bacterial lower respiratory tract infections (moderate evidence). ■ CT provides more information than plain radiographs for complicated pulmonary infections with empyema, pleural effusion, or bronchopleural fistula (moderate evidence). ■ In immunocompromised patients, CT has been shown to characterize the type of infection better than plain radiographs (moderate evidence). ■ Ultrasound has an advantage over CT in the identification and characterization of complicated effusions (moderate evidence). ■ Early detection and therefore intervention for pleural complications of pneumonia are critical and can result in better outcomes (moderate evidence). ■ Early surgery (VATS) is more cost-effective than thoracotomy (without or with image guidance) in the treatment of empyemas in children (strong evidence).