ABSTRACT
La bronquiolitis por virus sincitial respiratorio (USR) es una enfermedad de las vías aéreas pequeñas, caracterizada por inflamación y obstrucción de los bronquiolos. El VSR fue aislado por primera vez en 1995, pertenece a la familia de los paramixovirus. Es clara la presentación epidérmica anual que compromete especialmente a lactantes pequeños. La tasa de infección por VSR durante el primer año de vida alcanza el 69 por ciento y el 83 por ciento durante el segundo. La mortalidad en niños previamente sanos es del 0.005 por ciento al 0.002 por ciento; en pacientes hospitalizados es del 1 al 3 por ciento. Aunque se ha descrito que la infección por VSR no altera la función cardíaca en pacientes con corazón sano, se encuentra en la literatura informes aislados al respecto; a continuación presentamos un caso de un paciente con bronquiolitis por VSR, en el que se documentó miocarditis por este mismo germen.
Subject(s)
Humans , Infant , Male , Bronchiolitis, Viral/diagnosis , Bronchiolitis, Viral/drug therapy , Bronchiolitis, Viral/etiology , Bronchiolitis, Viral/history , Bronchiolitis, Viral/microbiology , Bronchiolitis, Viral/nursing , Myocarditis/classification , Myocarditis/drug therapy , Myocarditis/epidemiology , Myocarditis/history , Myocarditis/microbiology , Myocarditis/nursing , Myocarditis/physiopathology , Respiratory Syncytial Viruses/chemistry , Respiratory Syncytial Viruses/isolation & purification , Respiratory Syncytial Viruses/pathogenicity , Respiratory Syncytial Viruses/physiologyABSTRACT
Between may 1984 and november 1986, a study, which included 475 children under five years of age hospitalized due to acute intrathoracic respiratory infections, was carried out in order to obtain clinical, radiological and etiological characteristics which may aid in establishing norms to diagnose and treat these patients. Nasopharyngeal aspirations were performed on each child, while viral diagnosis was done through viral isolation techniques and indirect immunofluorescence. The presence of a virus was detected in 34.4% of the cases and in 28.8% of a subsample. A precoded questionnaire was used to obtain the clinical information needed and all X-rays were reviewed by the same radiologist using simple pre-established criteria. A comparison was made on the similarities found between both the clinical and radiological diagnosis, as well as the sensitivity and specificity of some of the clinical signs which characterize bronchiolitis and the pneumoniae.
Subject(s)
Bronchitis , Pneumonia, Viral , Acute Disease , Bronchiolitis, Viral/complications , Bronchiolitis, Viral/diagnostic imaging , Bronchiolitis, Viral/microbiology , Bronchiolitis, Viral/therapy , Bronchitis/diagnostic imaging , Bronchitis/microbiology , Female , Hospitalization , Humans , Infant , Infant, Newborn , Male , Pneumonia, Viral/complications , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/microbiology , Pneumonia, Viral/therapy , Prospective Studies , Radiography , UruguayABSTRACT
The aim of this study was to determine the viral agents associated with acute lower respiratory infections (ALRI) in young children. During a 2-yr period, 204 nasopharyngeal aspirates (NPA) from children under 4 yr of age living in an orphanage and exhibiting febrile ALRI were studied by both indirect immunofluorescence (IIF) and isolation in four cell lines. NPA cell smears as well as tissue culture cells exhibiting cytopathic effect (CPE) or hemadsorption were stained by IIF for respiratory syncytial virus (RSV), adenovirus, influenza A and B, and parainfluenza 1 and 3. Viral etiology was demonstrated in 21.2% of acute respiratory infection cases. The most frequently detected virus was RSV (53.5% of viral positive diagnoses), followed by unidentified viruses (18.6%), adenovirus (13.9%), influenza A (7%), and parainfluenza 3 (4.7%). The most common clinical entities were: bronchitis, 46.1%; pneumonia, 24%; bronchiolitis, 22%; and multifocal pneumonia, 8%. Malnourishment was found in 56% of children with ALRI, whereas 50% was found among total orphanage population. The 3 to 8-month-old age group accounted for half of all ALRI cases. Viral etiology was shown for 26.5% of patients with pneumonia, 22% with bronchitis, and 16% with bronchiolitis. RSV and adenovirus occurred in fall and winter, while parainfluenza 3 was detected in early spring. In the two fatal cases observed, histologic lesions were compatible with adenovirus infection, but this virus could be isolated from the lung in only one case.
Subject(s)
Respiratory Tract Infections/etiology , Virus Diseases/microbiology , Acute Disease , Bronchiolitis, Viral/microbiology , Bronchitis/microbiology , Child, Preschool , Complement Fixation Tests , Female , Fluorescent Antibody Technique , Humans , Infant , Infant, Newborn , Male , Nasopharynx/microbiology , Pneumonia, Viral/microbiology , Residential Facilities , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/microbiology , Virus Diseases/diagnosisABSTRACT
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Subject(s)
Humans , Male , Female , Infant , Child, Preschool , In Vitro Techniques , Respiratory Tract Infections , Streptococcus pneumoniae/isolation & purification , Haemophilus influenzae/isolation & purification , Staphylococcus aureus/isolation & purification , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/etiology , Respiratory Tract Infections/microbiology , Bronchiolitis, Viral/microbiology , Bronchiolitis, Viral/diagnosis , Lung Diseases/microbiology , Lung Diseases/diagnosisSubject(s)
Infant , Child, Preschool , Humans , Male , Female , History, 20th Century , Respiratory Tract Infections , Staphylococcus aureus/isolation & purification , Streptococcus pneumoniae/isolation & purification , Haemophilus influenzae/isolation & purification , In Vitro Techniques , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/etiology , Respiratory Tract Infections/microbiology , Bronchiolitis, Viral/diagnosis , Bronchiolitis, Viral/microbiology , Lung Diseases/diagnosis , Lung Diseases/microbiologySubject(s)
Bronchiolitis, Viral/epidemiology , Cross Infection/epidemiology , Disease Outbreaks/epidemiology , Paramyxoviridae Infections/epidemiology , Brazil , Bronchiolitis, Viral/microbiology , Child, Preschool , Cross Infection/microbiology , Female , Humans , Infant , Infant, Newborn , Male , Parainfluenza Virus 1, Human/isolation & purificationABSTRACT
To develop a broad understanding of the causes and patterns of occurrence of wheezing associated respiratory infections, we analyzed data from an 11-year study of acute lower respiratory illness in a pediatric practice. Although half of the WARI occurred in children less than 2 years of age, wheezing continued to be observed in 19% of children greater than 9 years of age who had lower respiratory illness. Males experienced LRI 1.25 times more often than did females; the relative risk of males for WARI was 1.35. A nonbacterial pathogen was recovered from 21% of patients with WARI; respiratory syncytial virus, parainfluenza virus types 1 and 3, adenoviruses, and Mycoplasma pneumoniae accounted for 81% of the isolates. Patient age influenced the pattern of recovery of these agents. The most common cause of WARI in children under 5 years of age was RSV whereas Mycoplasma pneumoniae was the most frequent isolate from school age children with wheezing illness. The data expand our understanding of the causes of WARI and are useful to diagnosticians and to researchers interested in the control of lower respiratory disease.