Etiology and Clinical Features of Severe Acute Viral Lower Respiratory Tract Infections in Children

Jeon, Noo Lee; Kim, Bong Seong; Kim, Yoo Kyum; Hong, Soo Jong

Abstract

PURPOSE: The purpose of the study is to understand the etiology and clinical features of severe acute viral lower respiratory tract infection(LRI), especially in conjunction with the use of ventilator care and/or with bronchiolitis obliterans.
METHODS
Etiologic agents and clinical features of severe acute viral LRI were studied from July 1998 through June 1999 in children at Asan Medical Center. The viruses were identified by shell viral technique. Medical records of children with proven viral LRI were reviewed retrospectively.
RESULTS
81 cases were confirmed as respiratory viral infection. The identified pathogens were influenza virus(32.1%), parainfluenza virus(PIV, 29.9%), respiratory syncytial virus(RSV, 16.0%), adenovirus(11.0%), and mixed viruses(11.0%). Clinical patterns of viral LRI were pneumonia(46.9%), bronchiolitis(38.3%), croup(7.4%), and tracheobronchitis(7.4%). 29.6 percents of patients had a fever of 38.5C degree or higher and their most common etiologic agent was influenza virus(33.3%). 30.8 percents of patients had fever for 5 days or more and their most common etiologic agent was RSV(31.3%). 35.8 percents of patients showed cyanosis and their most common etiologic agent was PIV(31.0%). CRP (more than 4.0mg/dL) was increased in 33.8%, and their common etiologic agents were RSV and PIV(29.9%). Abnormal liver function test was detected in 19.4%, and the most common etiologic agent was RSV(50.0%). 5 patients(6.2%) showed clinical and radiologic findings consistent with bronchiolitis obliterans and their most common etiologic agent was influenza virus(60.0%).
CONCLUSION
Influenza virus, PIV, and RSV were common etiologic agents in severe viral respiratory tract infection in children.