ABSTRACT
Objective:To investigate the clinical characteristics of acute lower respiratory tract infection (ALRTI) in neonates caused by respiratory syncytial virus (RSV), and to analyze the factors associated with the severe infection.Methods:Clinical data of 399 ALRTI neonates with positive nucleic acids or antigen of RSV admitted to Shenzhen Children′s Hospital from January 2014 to December 2020 were retrospectively analyzed for their clinical cha-racteristics.They were divided into mild-to-moderate group and severe group according to the severity index (SI), and the clinical data of the 2 groups were compared.Relevant factors of severe ALRTI of RSV in neonates were analyzed by multivariate Logistic regression. Results:(1) A total of 399 ALRTI neonates with RSV infection were included, involving 239 males (59.9%) and 160 females (40.1%) with a male-to-female ratio of 1.49∶1.00.There were 349 cases (87.5%) and 50 cases (12.5%) in the mild-to-moderate group and severe group, respectively.The disease mainly occurred from March to October.(2) There were significant differences in the preterm delivery [15 cases (4.3%) vs.9 cases (18.0%)], low birth weight [11 cases (3.2%) vs.6 cases (12.0%)], previous hospitalization history [12 cases (3.4%) vs.5 cases (10.0%)], and breastfeeding [167 cases (47.9%) vs.16 cases (32.0%)] between the mild-to-moderate group and severe group ( χ2=14.524, 8.394, 4.616 and 4.426, respectively, all P<0.05). (3) There were significant differences in fever [78 cases (22.4%) vs.18 cases (36.0%)], shortness of breath [156 cases (44.7%) vs.36 cases (72.0%)], poor appetite [48 cases (13.8%) vs.15 cases (30.0%)], wheezing [20 cases (5.7%) vs.10 cases (20.0%)], cyanosis [30 cases (8.0%) vs.16 cases (32.0%)] and mental status (irritability/malaise) [20 cases (5.7%) vs.8 cases (16.0%)], and duration of cough[(8.1±2.6) days vs.(9.4±2.9) days ] between the mild-to-moderate group and severe group ( χ2=4.460, 13.057, 8.682, 12.806, 23.486 and 7.068, t=-3.054, all P<0.05). Moist rales in the lungs [29 cases (58.0%) vs.114 cases (32.7%)] and three concave signs [14 cases (28.0%) vs.20 cases (5.7%)] were commonly found in the severe group, while pulmonary phlegm sounds [168 cases (48.1%) vs.14 cases (28.0%)]was commonly found in the mild-to-moderate group, and the differences were statistically significant ( χ2=12.208, 27.823 and 7.149, respectively, all P<0.05). (4) Multifactorial analysis showed that premature delivery was an independent risk factor for the development of severe ALRTI caused by RSV in neonates ( OR=3.717, 95% CI: 1.257-10.987), and shortness of breath ( OR=2.216, 95% CI: 1.061-4.629), cyanosis ( OR=3.621, 95% CI: 1.638-8.004) and three concave signs ( OR=2.688, 95% CI: 1.077-6.711) may be early warning factors for the severe condition. Conclusions:Preterm infants with RSV infection are prone to develop into severe disease, and neonates with RSV infection with shortness of breath, cyanosis and three concave signs as symptoms of severe infection should be well concerned for a close monitoring.
ABSTRACT
Background: Acute respiratory infections (ARIs) are the leading cause of death among children less than 5 years in India. Poverty and malnutrition underlie both the high incidence and deaths of young children from pneumonia in SEAR countries.Methods: A hospital based prospective observational study was conducted in a tertiary care hospital. A total of 200 children admitted with signs of ALRI were included in the study. A portable oximeter was used to measure oxygen saturation with an appropriately sized sensor on the finger or the toe. Weight was recorded on a standardized digital weighing scale and plotted on standard WHO weight for age chart. Chi-square test was used to test the significance.Results: Out of 200 children studied hypoxemia was present in 90 children with a percentage of 45% and absent in 110 children with a percentage of 55%. Out of 90 children who had hypoxemia, 40 children had weight less than 3rd centile. Out 110 children who had did not have hypoxemia, only 24 children had weight less than 3rd centile. It was observed that children with Weight for age less than 3rd centile according to standard WHO charts had higher incidence of hypoxemia. This correlation was statistically significant at p value of 0.001.Conclusions: Based on the results of this study hypoxemia is widely prevalent in children aged between six months to five years presenting with acute lower respiratory tract infection. There was significant correlation with weight and hypoxemia in children aged between six months to five years with acute lower respiratory tract infection.
ABSTRACT
Background: Anemia and ALRI are quite common in infants and toddlers in developing countries. ALRI is a leading cause of mortality in children below 5 years of age and it is important to prevent risk factors for development of ALRI. Present study was conducted to know the prevalence of anemia in children between 6 m to 23 m with ALRI and the relation between ALRI and anemia.Methods: This is a prospective case control study, conducted at Level 2 hospital situated in backward district over a period of 1 year. Two hundred cases who had ALRI as per WHO criteria and 200 controls were taken as the study group. Children were divided in to 3 different age groups. Haemoglobin level was estimated in all.Anemia was defined and classified according to WHO criteria.Results: Out of total 200 children both in cases and controls, 128 (64%) were males and 72 (36%) were females. Overall 190 (95%) of cases and 187 (93.5%) of controls had anemia. The prevalence of anemia was uniform in both sexes and all age groups. Children in the age group 6m -11m were more likely to develop ALRI.Conclusions: Prevalance of anemia in children between 6 m to 23 m with ALRI and without ALRI was 93.5% and 95% respectively. Authors cannot declare with affirmation that there was no association between Hb levels and ALRI as prevalence of anemia was very high in control group. Screening all children for anemia and taking proper intervention measures is necessary while treating for other ailments like ALRI.
ABSTRACT
Introducción. La infección respiratoria aguda baja por adenovirus es una importante causa de morbimortalidad en niños. Objetivos: Describir el patrón clínico-epidemiológico y los factores asociados en niños hospitalizados.Métodos. Estudio transversal en niños ingresados por infección respiratoria aguda baja al Hospital de Niños Ricardo Gutiérrez, Buenos Aires, en 2000-2018. El diagnóstico viral se realizó mediante inmunofluorescencia indirecta en secreciones nasofaríngeas. Se compararon características clínico-epidemiológicas de infección por adenovirus con otros virus respiratorios (virus sincicial respiratorio, influenza y parainfluenza). Se utilizó regresión logística múltiple para identificar predictores independientes de infección.Resultados. De 16018 pacientes con infección respiratoria aguda baja, 13545 fueron testeados para virus respiratorios y 6047 (el 45 %) fueron positivos. Adenovirus fue el agente menos frecuente [el 4,4 % (265) de los casos]; presentó una tendencia en descenso durante todo el período estudiado (pico en 2003) y circuló durante todo el año (pico en julio). El 63,8 % eran varones; mediana de edad: 11 meses (rango intercuartílico: 6-20). La presentación clínica más frecuente fue neumonía (el 63 %). El 50 % tenía internaciones previas por causa respiratoria; el 15,6 % eran reingresos; el 58,3 % tenía comorbilidades. El 19,2 % requirió asistencia ventilatoria; el 44 %registró complicaciones. La letalidad fue del 7,7 %. La infección por adenovirus se asoció a edad ≥ 12 meses, sexo masculino, presentación clínica de neumonía, internaciones previas por causas respiratorias y reinternaciones.Conclusiones. Los adenovirus fueron detectados con menor frecuencia que los otros virus respiratorios, aunque presentaron un importante perfil de morbimortalidad
Introduction. Acute lower respiratory tract infection (ALRTI) caused by adenovirus is a major cause of morbidity and mortality in children.Objectives. To describe the clinical and epidemiological pattern and associated factors in hospitalized children.Methods. Cross-sectional study in children admitted due to ALRTI to Hospital de Niños "Ricardo Gutiérrez," in the Autonomous City of Buenos Aires, between 2000 and 2018. Viral diagnosis was done by indirect immunofluorescence in nasopharyngeal secretions. The clinical and epidemiological characteristics of adenovirus infection were compared to other respiratory viruses (respiratory syncytial virus, influenza, and parainfluenza). A multiple logistic regression was done to identify independent predictors of infection.Results. Out of 16 018 patients with ALRTI, 13 545 were tested for respiratory viruses; 6047 (45 %) had a positive result. Adenovirus was the least common agent (4.4 % [265] of cases); it tended towards a reduction over the study period (peak in 2003) and circulated throughout the year (peak in July). In total, 63.8 % of patients were males; median age: 11 months (interquartile range: 6-20). The most common clinical presentation was pneumonia (63 %). Prior admissions due to respiratory conditions were seen in 50 %; 15.6 %were readmissions; 58.3 % had comorbidities. Ventilatory support was required by 19.2 %and complications were recorded in 44 %. The fatality rate was 7.7 %. Adenovirus infection was associated with age ≥ 12 months, male sex, clinical presentation of pneumonia, prior admissions due to respiratory conditions, and readmissions.Conclusions. Adenoviruses were less common than other respiratory viruses, although their morbidity and mortality were important
Subject(s)
Humans , Male , Female , Infant , Respiratory Tract Infections/epidemiology , Adenoviridae Infections/epidemiology , Pneumonia , Respiratory Tract Infections/virology , Epidemiologic Studies , Child, Hospitalized , Cross-Sectional Studies , Adenoviridae Infections/diagnosis , Fluorescent Antibody Technique, IndirectABSTRACT
Objective To analyze the pathogenic epidemiological characteristics of acute lower respiratory tract infection(ALRTI) in children in Gansu Province from 2012 to 2015. Methods The surveillance data of 458 children infected with ALRTI in 10 sentinel hospitals in Gansu province from 2012 to 2015 were collected, and infection status and epidemiological characteristics of each virus and bacteria were analyzed by descriptive study methods. Results The male to female ratio of the 458 children with ALRTI was 1.81:1, and the positive detection rate of the virus was 33.62%（95% CI：29.28%-37.97%), among which the positive detection rate of respiratory syncytial virus was the highest (12.23%).The positive detection rate of bacteria was 24.84%（95% CI：20.04%-29.65%),among which the positive detection rate of streptococcus pneumoniae was the highest (18.47%).There was significant no difference in the positive detection rate of virus and bacteria between children of different genders (P>0.05).There was significant no difference in the positive detection rate of virus among children of different age groups ( 2=5.980,P=0.050), but the positive detection rate of bacteria was different ( 2=12.078,P=0.002).Positive detection rates of virus infection and bacterial infection were different in distinct seasons (all P<0.05). By using logistics regression analysis, season, age and sentinel hospital were the influencing factors of ALRTI virus infection in children (all P<0.05), and sentinel hospital and years were the influencing factors of ALRTI bacterial infection in children (all P<0.05). Conclusion Respiratory syncytial virus, influenza virus and parainfluenza were the main causes of ALRTI virus infection in children aged 0-14 years in Gansu province, and the main bacterial infections were streptococcus pneumoniae and haemophilus influenzae, the number of virus infection was more than that of bacterial infection. Viral and bacterial infection had the same peak incidence.
ABSTRACT
Background: Acute Lower Respiratory Tract Infections (ALRTI) remains the major cause of increased morbidity and mortality in under-five children. Vitamin A has a protective role against infections in children. Vitamin A supplementation is given to under-five children as part of the National Immunization Programme in India. The aim of this study was to find out the effectiveness of vitamin A supplementation in preventing the recurrent ALRTI (?3 episodes per year) in under-five children.Methods: A cross-sectional analytical study was conducted to find out the role of vitamin A supplementation in reducing recurrent ALRTI in under-five children who were enrolled in Anganwadi centers (AWC's) in Villupuram district, Tamil Nadu, India. Two hundred children of 1-5 years of age were selected by random systematic sampling. History was elicited and documents about vitamin A supplementation and previous episodes of ALRTI were verified. The association between recurrence of ALRTI and vitamin A supplementation was analyzed using chi-square test.Results: The mean age of the children in this study is 24'8 months. The median number of episodes of ALRTI per year is 2 (1-3). Among 200 children enrolled in the study, 127 (63.5%) children received vitamin A supplementation and 73 (36.5%) did not receive it. There is a significant decrease in the number of ALRTI episodes (less than 3 episodes per year) in the children who received vitamin A supplementation (p <0.001).Conclusions: Vitamin A supplementation along with the National Immunization Programme had shown reduced' ALRTI episodes. Since, the number of ALTRI episodes are directly proportional to mortality due to pneumonia, reduction in number of episodes can decrease the Under-five mortality. Vitamin A supplementation is an important programme in this regard and needs to be scrupulously carried out.
ABSTRACT
Objective To explore the clinical characteristics of acute lower respiratory tract infection in children after influenza,and to provide evidence-based basis for timely diagnosis and accurate treatment of acute lower respiratory tract infection in children after influenza. Methods Eighty- two patients with acute lower respiratory tract infection admitted to Shanghai Children′ s Medical Center from October 2016 to November 2017 were enrolled in our study. The clinical data of these patients were analyzed and influenza A or influenza B were confirmed by Filmarray platform. The clinical characteristics of patients with influenza A and influenza B,severe pneumonia and non-severe pneumonia,mechanical ventilation and non-mechanical ventilation were compared. Results The age distribution of the children ranged from 0. 13 to 15 years old, with 73 cases (89. 0％ ) being younger than 5 years old. There were 47 cases of influenza A (57. 3％ ) and 35 cases of influenza B (42. 7％ ). The proportions of cases in spring,summer,autumn and winter were 35. 3％ ,15. 9％ ,15. 9％ and 32. 9％ ,respectively. Congenital heart disease was the most common underlying disease (28 cases,34. 1％ ). Twenty-five(30. 5％ ) patients were diagnosed as severe pneumonia. Oseltamivir was added on the first to eighth days of the course with median time ( IQR) 2. 0 (3. 0) days. Thirteen (15. 9％ ) patients needed ventilator-assisted ventilation. There were significant differences in the incidence of influenza A and influenza B in summer (12 / 47 vs. 1 / 35,χ2 = 7. 7,P < 0. 01). Compared to non-severe pneu-monia,severe pneumonia was positively correlated with underlying diseases(17 / 25 vs. 18 / 57,χ2 = 9. 4,P <0. 01),digestive tract symptoms(10 / 25 vs. 6 / 57,χ2 = 9. 6,P < 0. 01) and high PCT level(8 / 23 vs. 8 / 56,χ2 = 3. 1,P < 0. 01),but negatively correlated with oseltamivir application[M(IQR)] [5. 0(2. 5) d vs. 2. 0 (1. 5)d,Z = - 6. 1,P < 0. 01]. There was significant difference in the proportion of influenza A/ B between ventilator group and non-ventilator group (11 / 2 vs. 36 / 33,χ2 = 4. 7,P < 0. 01). Conclusion Filmarray re-spiratory tract detection system can detect influenza virus infection quickly and accurately,providing a good basis for early diagnosis and treatment. Children under 5 years old are susceptible to influenza. Influenza in children mainly occurs in winter and spring. Influenza A mainly occurs in summer. Patients with influenza A infection,underlying diseases,digestive tract symptoms during the course of illness and elevated PCT are more likely to progress to severe illness or even use ventilator treatment. Early use of oseltamivir can improve the prognosis of the disease.
ABSTRACT
PURPOSE: This study evaluated the characteristics and symptoms of full-term newborns without risk factors who were diagnosed with acute lower respiratory tract infections (ALRI). METHODS: Nasopharyngeal aspirates were obtained from 72 full-term newborns to 30 days of age who were diagnosed with ALRI from September 2011 to November 2013 and analyzed by multiplex real time-polymerase chain reaction (RT-PCR). RESULTS: Viruses were detected in 60 newborns (83.3%). Single viruses were observed in 56 newborns (77.7%). The most commonly detected viral agent was respiratory syncytial virus (RSV) (63.8%), followed by parainfluenza virus (6.9%), rhinovirus A/B (4.1%), and human coronavirus (2.7%). Clinical diagnoses of ALRI in newborns with a single virus included pneumonia (66.07%), bronchiolitis (30.43%), bronchitis (5.35 %), and croup (1.79%). There were no differences in epidemiological characteristics between RSV and other viruses. However, newborns diagnosed with RSV had prolonged hospitalizations and significantly increased respiratory rates. CONCLUSION: Respiratory viruses, especially RSV, are pivotal causes of ALRI in newborns. Further, studies on RSV severity and vaccination are necessary to reduce hospitalization and mortality of full-term infants.
Subject(s)
Humans , Infant , Infant, Newborn , Bronchiolitis , Bronchitis , Coronavirus , Croup , Diagnosis , Hospitalization , Mortality , Paramyxoviridae Infections , Pneumonia , Respiratory Rate , Respiratory Syncytial Viruses , Respiratory Tract Infections , Rhinovirus , Risk Factors , VaccinationABSTRACT
Context: Acute lower respiratory tract infections (ALRI), ranked as the second leading cause of death are the primary cause of hospitalisation in children. Viruses are the most important causative agents of ALRI. Aim: To study the viral aetiology of ALRI in children at a tertiary care hospital. Setting and Design: One year prospective observational study in a tertiary care hospital of King George’s Medical University, Lucknow. Material and Methods: Nasopharyngeal aspirate (NPA) was collected from children admitted with signs and symptoms of ALRI who were aged 0-14 years. Samples were transported to the laboratory at 4°C in viral transport media and processed for detection of respiratory syncytial virus (RSV) A and B, infl uenza virus A and B, adenovirus (ADV), human Boca virus (HBoV), human metapneumo virus (hMPV) and parainfl uenzavirus 1, 2, 3 and 4 using mono/multiplex real-time polymerase chain reaction (RT-PCR). STATA was used for statistical analysis. Results: In one year, 188 NPAs were screened for respiratory viruses, of which 45.7% tested positive. RSV was most commonly detected with 21.3% positivity followed by measles virus (8.5%), infl uenza A virus (7.4%), ADV (5.3%), infl uenza B virus (1.6%), hMPV (1.1%) and HBoV (0.5%). Month wise maximum positivity was seen in December and January. Positivity rate of RSV was highest in children aged < 1 year, which decreased with increase in age, while positive rate of infl uenza virus increased with increasing age. Conclusion: The occurrence of viral predominance in ALRI is highlighted.
ABSTRACT
Objective: To identify the outcome of acute lower respiratory tract infection (ALRTI) and factors contributing in mortality. Design: Prospective cohort study. Setting: Urban tertiary care teaching hospital. Methods: 100 cases with ALRTI between 2 weeks to 5 years of age were prospectively enrolled and followed up to determine outcome. Detailed history and clinical evaluation were recorded on a pre-tested proforma.Outcome and significant independent factors contributing to mortality were determined by comparison of dead subjects (n=10) with surviving children (n=90) in a multiple logistic analytic framework. Results: The case fatality rate (CFR) was 10%. The significant (p <0.05) independent factors contributing to mortality were pallor (OR 10.7), age less than 1 year (OR 9.4), inability to feed (OR 9.3), weight for age Z score (WAZ) <-3 (OR 6.6), presence of loose stools (OR 5.3), Hb<10(OR 1.6). The CFR was related to severity of WHO classification (“pneumonia”-0%, “severe pneumonia”-8.7% and “very severe pneumonia”-47.0%). Factors contributing to prolonged hospital stay included lack of exclusive breastfeeding [OR (95%CI)-4.37(1.69-11.28) RR (2.04)] and fever [OR (95%CI)-5.59(1.92-16.2) RR (2.3)] on multivariate analysis. Conclusion: ALRTI in children is a major concern. Presence of factors like pallor, age below 1 year, inability to feed, presence of loose stools and severe malnutrition require urgent intervention.
Subject(s)
Child, Preschool , Fatal Outcome , Female , Humans , Infant , Infant, Newborn , Male , Multivariate Analysis , Pneumonia/epidemiology , Pneumonia/etiology , Pneumonia/mortality , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Respiratory Tract Infections/mortalityABSTRACT
Objective To elucidate the etiology feature of viral infection in hospitalized children with acute lower respiratory infection. Methods A total of 5 480 children with acute lower respiratory tract infection, hospitalized from September 2007 to September 2009, were studied. Nasopharyngeal aspirates were screened for 8 types of viruses by direct immunofluorescence (DIF) assay. Results At least one type of viral pathogen was detected in 2 710 out of 5 480 patients and the overall positive rate was 49.5%. The most common virus was RSV (51.1%), followed by hMPV (18.9%), PIVⅢ (12.5%), ADV (7.1%), IFA (4.7%), IFB (2.9%), PIV Ⅰ (1.5%) and PIV Ⅱ (1.2%). The positive rate was highest in children under 6 months (43.5%). The seasonal change of RSV, hMPV was more obvious. The peak of RSV, hMPV appeared in the winter and the spring. The prevalence of viral infection in children with pneumonia, bronchitis, asthmatic bronchitis, non asthmatic bronchitis and asthma were 47.4%、63.6%、 50.5%、 30.1% and 43.5% respectively. Conclusions Viruses are the main cause of lower respiratory tract infections in children, especially in infants and young children. RSV and hMPV were the most common viruses in these years.
ABSTRACT
Objective To understand the clinical and molecular epidemiologic features of human metapneumovirus (hMPV) in children with acute lower respiratory tract infection (ALRTI)from Oct.2006 to Feb.2008 in Shanghai.Methods We established a reliable and stable diagnostic method of TaqMan-MGB real-time reverse transcription polymerase chain reaction (RT-PCR) to detect hMPV in the clinically manifested respiratory samples.To understand the role of hMPV in children' s ALRTI,we tested other seven common respiratory viruses,using direct immunofluorescence assays (DFA).Results Data was analysed on the rates of detection among patients with respiratory bacteria,mycoplasma pneumonia and chlamydia among the targeted samples and enrolled patients to display the spectrum of respiratory pathogens and the changing pattern of pathogens with time.Of 622 samples,hMPV was detected to be positive in 24 (3.86%) samples.However,the prevalence of hMPV in the winter season of 2006 to 2007 was higher than that in the winter season of 2007 to 2008.The majority of children infected with hMPV were younger than 5 years old.Data from phylogenetic tree analysis further demonstrated A2 genotype hMPV circulating during the study period.Conclusion Respiratory viruses were important respiratory pathogens among children with ALRTI and respiratory syncytial virus.They were the two most common virus which might be followed by hMPV that causing the diseases.We confirmed that hMPV as an important pathogen of ALRTI in the children from Shanghai.
ABSTRACT
Acute lower respiratory tract infection (ALRTI) is a common illness, but there have been relatively few studies of the bacterial etiology in developing countries. Nasopharyngeal aspirates of 70 children under 10 years of age with ALRTI were cultured for aerobic bacterial pathogens. Klebsiella pneumoniae was the commonest organism (32.2%) isolated followed by S. pneumoniae (10%), E. coli (10%), P. aeruginosa (5.7%), S. aureus (2.8%) and H. influenzae (1.4%). There were significantly more bacterial pathogens isolated in children <1 year of age (73.7%) than in those >1 year of age (56.2%) (P=0.03). A shift in spectrum from Gram-positive cocci to Gram-negative bacilli in ALRTI was observed in our study.
Subject(s)
Acute Disease , Age Factors , Bacteria, Aerobic/classification , Bacteria, Aerobic/isolation & purification , Child, Preschool , Developing Countries , Humans , India , Infant , Microbial Sensitivity Tests , Prospective Studies , Respiratory Tract Infections/microbiology , Species SpecificityABSTRACT
PURPOSE: This study was performed to characterize the epidemiologic and clinical features of acute adenoviral lower respiratory tract infections. METHODS: Culture and indirect immunofluorescence for adenovirus was done with nasopharyngeal aspirates from patients with acute lower respiratory tract infections from April to September, 1996. Cultured virus was serotyped for type 3, 4, and 7a by neutralization test, and medical records were reviewed. RESULTS: Adenovirus was isolated from 29 of 187 (15.5%) patients. Monthly distribution from May to September, 1996 was 4, 17, 7, 0, and 1 case, respectively. Seventeen out of 18 cases serotyped (94.4%) were type 7. Male to female ratio was 21:8 and ranged in age from 1 month to 8 years with a mean of 22.6 +/- 22.5 months. Clinical diagnosis was pneumonia in 18, tracheobronchitis in 6, and bronchiolitis in 4 cases. The main clinical features were cough (100%), sputum (100%), fever (89%), pharyngeal injection (85%), increased ESR (76%) and CRP (64%), and leukocytosis (59%). Radiologic findings of chest, included consolidation (40.7%), parahilar peribronchial infiltration (22.2 %), pleural effusion (7.4%), and hyperaeration (3.7%). The mean duration of admission was 8.9 +/- 5.1 days and all the patients showed favorable clinical outcome without acute respiratory distress syndrome. CONCLUSION: There was a respiratory epidemic by adenovirus between May and July, 1996, and 17 out of 18 cases serotyped was type 7. All of the 29 patients with acute adenoviral lower respiratory tract infections improved without significant complication.
Subject(s)
Child , Female , Humans , Male , Adenoviridae , Bronchiolitis , Cough , Diagnosis , Fever , Fluorescent Antibody Technique, Indirect , Leukocytosis , Medical Records , Neutralization Tests , Pleural Effusion , Pneumonia , Respiratory Distress Syndrome , Respiratory System , Respiratory Tract Infections , Sputum , ThoraxABSTRACT
PURPOSE: This study was performed to characterize the epidemiologic and clinical features of acute adenoviral lower respiratory tract infections. METHODS: Culture and indirect immunofluorescence for adenovirus was done with nasopharyngeal aspirates from patients with acute lower respiratory tract infections from April to September, 1996. Cultured virus was serotyped for type 3, 4, and 7a by neutralization test, and medical records were reviewed. RESULTS: Adenovirus was isolated from 29 of 187 (15.5%) patients. Monthly distribution from May to September, 1996 was 4, 17, 7, 0, and 1 case, respectively. Seventeen out of 18 cases serotyped (94.4%) were type 7. Male to female ratio was 21:8 and ranged in age from 1 month to 8 years with a mean of 22.6 +/- 22.5 months. Clinical diagnosis was pneumonia in 18, tracheobronchitis in 6, and bronchiolitis in 4 cases. The main clinical features were cough (100%), sputum (100%), fever (89%), pharyngeal injection (85%), increased ESR (76%) and CRP (64%), and leukocytosis (59%). Radiologic findings of chest, included consolidation (40.7%), parahilar peribronchial infiltration (22.2 %), pleural effusion (7.4%), and hyperaeration (3.7%). The mean duration of admission was 8.9 +/- 5.1 days and all the patients showed favorable clinical outcome without acute respiratory distress syndrome. CONCLUSION: There was a respiratory epidemic by adenovirus between May and July, 1996, and 17 out of 18 cases serotyped was type 7. All of the 29 patients with acute adenoviral lower respiratory tract infections improved without significant complication.