A Clinical Study on Acute Lower Respiratory Tract Infections by Adenovirus in Children

ABSTRACT

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 218 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.