Risks for bacteremia and urinary tract infections in febrile young children with respiratory syncytial virus-bronchiolitis

ABSTRACT

This study was done to evaluate the risks of bacteremia and urinary tact infections [UTI] in febrile patients with respiratory syncytial virus [RSV] -bronchiolitis. One hundred infants and children were selected from emergency department [ED] and outpatient clinic of El-Minia University and El-Galaa Teaching Hospital. They were divided into three groups bronchiolitis group [40 patients], group of febrile children without obvious cause for fever [30 patients], and control group of normal healthy non febrile children [30 infants and children]. Apart from thorough physical examination, they were investigated for respiratory syncytial virus [RSV] detection in nasal aspirate, bacterial infections by WBCs count, absolute neutrophil count [ANC] and absolute band count [ABC], bacteremia by blood culture, and UTI by urine culture and bacterial count. We found a significant difference on comparison, for temperature, WBCs count, ANC, and ABC, between group with bronchiolitis only and control group on one hand and between febrile group without bronchiolitis and control group on the other hand [p <0.0001]. While on comparison between group with bronchiolitis only and febrile group without bronchiolitis, the difference between them for the same risk factors was not statistically significant [p >0.05]. Also, patients in group with bronchiolitis had more abnormal X- ray chest findings than those in the other two groups. On the other hand, more positive cases for blood culture and bacterial cell count were found among patients in febrile group without bronchiolitis [46.6% and 40% respectively] than among those in group with bronchiolitis [32.5% and 20% respectively] and control group [0.00%]. We recorded high risk of bacteremia and UTI in febrile patients of RSV bronchiolitis but less than that of febrile patients without focal infections. Therefore, evaluation of RSV bronchiolitis for bacterial infections including bacteremia and UTI may be necessary especially in developing counties