ABSTRACT
Respiratory tract infection is a leading cause of out⁃patient treatment and mortality in children under 5 years. Re⁃spiratory virus is the most common pathogen in children with respiratory tract infection,which should be paid attention to in pediatricians. The review discusses epidemiologic characteristics of common respiratory virus,focusing on respiratory syncytial virus(RSV),influenza virus,human rhinovirus(HRV)and human adenoviruses(HADV). The paper also briefly introduces the epidemiological characteristics of the newly discovered viruses,such as parainfluenza virus(PIV),human metapneumovirus (HMPV),human coronavirus(HCoV). At last,the information of viral-viral coinfections in children is reviewed.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the incidence and clinical features of mixed infections in children with Mycoplasma pneumoniae (MP) pneumonia.</p><p><b>METHOD</b>A total of 201 cases diagnosed as MP pneumonia were investigated for mixed infections by sputum bacterial culture, respiratory virus antigen detection and serum Chlamydia pneumoniae antibody test. For those with the indications for bronchoscopy, we also did bronchoalveolar lavage and lavage bacterial culture.</p><p><b>RESULT</b>A high incidence (103/201, 51.2%) of mixed infections in children with MP pneumonia was revealed. The most frequent co-infected pathogen was Chlamydia pneumoniae (52, 25.9%), followed by viruses (29, 14.4%), and bacteria (22, 10.9%). Among viruses, respiratory syncytial virus was the most common (17, 8.5%), followed by adenovirus (6, 3.0%), parainfluenza virus type III (4, 2.0%) and influenza virus type B (2, 1.0%). Sputum bacterial culture was positive in 14/201 (7.0%) cases, Streptococcus pneumonia being most common (6, 3.0%). BALF culture yielded positive results in 11.6% (8/69), Streptococcus pneumonia was also common (5, 7.3%). Among 29 cases with MP and virus coinfection, 26 were younger than 3 years (89.7%), while for MP and Chlamydia pneumoniae coinfection, most of them were older than 3 years (40/52, 76.9%). Compared with non-mixed infections, those with mixed infections had longer fever duration (24.5% and 40.8% longer than 10 d), more frequently developed pleural effusion (11.2%, 23.3%) and large area of shadow in chest imaging (35.7%, 51.5%). White blood cell [(14.28 ± 4.99) × 10(9)/L], C-reactive protein (CRP) [69(32.5 - 99.5) mg/L] and neutrophil ratio in BALF [0.86 (0.63 - 0.91)] were much higher in children with mixed bacterial infections than that in non-mixed infections [(9.06 ± 3.47) × 10(9)/L, 3 (0 - 31.0) mg/L, 0.44 (0.03 - 0.88)]. But no significant difference was found in peripheral blood neutrophil proportion between mixed bacterial infections (0.38 ± 0.25) and non-mixed infections (0.51 ± 0.19).</p><p><b>CONCLUSION</b>More than half of cases with MP pneumonia had mixed infections, most commonly caused by Chlamydia pneumonia followed by viruses. The incidence of mixed infections with bacteria was low. Mixed infections with virus were more common in young children, while mixed infection with Chlamydia pneumoniae was more common in older ones. Bacterial infections should be paid more attention, especially those caused by Streptococcus pneumoniae, for those with high peripheral white blood cell counts, high CRP levels and high proportion of neutrophils in BALF.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Chlamydophila pneumoniae , Coinfection , Inpatients , Mycoplasma pneumoniae , Pneumonia, Mycoplasma , Diagnosis , Microbiology , Virology , Pneumonia, Viral , Diagnosis , Respiratory Syncytial VirusesABSTRACT
<p><b>OBJECTIVE</b>To study the value of bronchofibroscopy in the etiologic identification of chronic cough in children.</p><p><b>METHODS</b>Under local anesthesia of lidocaine, bronchofibroscopy was performed in 118 children with chronic cough of unknown origin (73 males and 45 females). Their ages ranged from 3 months to 13 years.</p><p><b>RESULTS</b>The cause of chronic cough was identified in 115 cases. The most common cause was respiratory infection (n=39),followed by bronchial foreign bodies (n=19), upper airway cough syndrome (n=17), bronchial asthma or cough variant asthma (n=17), bronchomalacia (n=7), bronchial congenital malformation (n=5), primary ciliary dyskinesia (n=3), gastro-esophageal reflux (n=3), bronchial tumor (n=2), bronchial tuberculosis (n=1), pulmonary fibrosis (n=1) and idiopathic pulmonary hemosiderosis (n=1).</p><p><b>CONCLUSIONS</b>Bronchofibroscopy is useful in the etiologic identification of chronic cough in children.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Bronchoscopy , Methods , Chronic Disease , Cough , Diagnosis , TherapeuticsABSTRACT
Objective To study the present situation of legionella pneumophila(Lp) infection of low respiratory tract infection in children less than 5 years old.Methods Three hundred hospitalized patients with the diagnosis of low respiratory tract infection were enrolled in the study,191 males,109 females,aged 27 d to 5 years old,course from 1 d to 6 months.Serum antibody(IgM,IgG) of Lp serogroup 1-7 was detected by enzyme-linked immunosorbent assay(ELISA).Results In the patients,17 cases were positive,and the positive rate was 5.67%.Of the 17 children,the males(n=11) and females(n=6) did not significantly influence the positive rate(5.76% vs 5.50%).Four of them were between 27 days and 1 year old;7 were 1 to 3 years old,6 were 3 to 5 years old.The positive rates were significantly different among the 3 groups(2.53% vs 7.37% vs 12.77%) and tendentially increased following the increase of age(?2=7.8164 P