This study underscores the clinical utility of LUS in distinguishing bacterial from viral pneumonia in pediatric patients with LRTIs. Bacterial infections were associated with more severe lung involvement, as evidenced by significantly higher LUSS, increased frequency of pleural abnormalities, and the presence of large consolidations. In contrast, viral pneumonia exhibited a more diffuse pattern of interstitial involvement, with lower LUSS and fewer large consolidations.

The high sensitivity and specificity of LUS findings, particularly the presence of large consolidations, suggest that lung ultrasound can serve as a reliable diagnostic tool for pneumonia etiology differentiation in children. Implementing LUS in routine clinical practice may enhance diagnostic accuracy, optimize treatment decisions, and reduce unnecessary antibiotic use, ultimately improving pediatric patient outcomes.