Allergy Asthma Respir Dis.  2016 Jan;4(1):38-43. 10.4168/aard.2016.4.1.38.

Clinical considerations of febrile infants with respiratory symptoms according to the respiratory viral detection

• Bag N
• Jung JA
• Kwon KA

• KMID: 2218617
• DOI: http://doi.org/10.4168/aard.2016.4.1.38

Abstract

PURPOSE
Respiratory viral infection is one of the most common diseases in febrile infants. This study evaluates the clinical characteristics of febrile infants who were hospitalized for respiratory symptoms, with or without respiratory viral detection.
METHODS
Seventy-six hospitalized infants aged 28-90 days with fever and respiratory symptoms from January 2011 to December 2012 were enrolled in this study. We performed reverse transcriptase polymerase chain reaction to identify 7 respiratory viruses from nasopharyngeal swabs. Also, we retrospectively reviewed the medical records to analyze the clinical features.
RESULTS
Respiratory viruses were detected in 45 patients (RVP group). Respiratory syncytial virus (n=16) was most frequently detected, followed by human rhinovirus (n=10). Age, sex, past illness, and sibling's respiratory symptoms showed no differences between the 2 groups. Infants in the RVP group had a significantly higher incidence of tachypnea (22.2%) and abnormal breathing sounds (wheezing and rales, 57.8%) than those in the negative group (P=0.021, P=0.002 each). There were no significant differences in laboratory findings between the 2 groups.
CONCLUSION
In our study, RSV was the most common virus in febrile infants aged 28-90 days with respiratory symptoms. Tachypnea and abnormal breathing sounds were more reliable clinical features to guess the detection of respiratory viruses. Further studies are required to confirm the values of these clinical features in febrile infants who have lower respiratory tract infections.

Keyword

Fever; Respiratory symptoms; Infants; Respiratory viruses

MeSH Terms

Fever
Humans
Incidence
Infant*
Medical Records
Respiratory Sounds
Respiratory Syncytial Viruses
Respiratory Tract Infections
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction
Rhinovirus
Tachypnea

Figure

• 

  Fig. 1 Numbers of detected viruses in respiratory virus positive group. Parainfluenza virus and adenovirus (n=1), parainfluenza virus and influenza A virus (n=1), parainfluenza virus and metapneumovirus (n=1), respiratory syncytial virus and rhinovirus (n=1). RSV, respiratory syncytial virus; hRV, human rhinovirus; PIV, parainfluenza virus; hMPV, human metapneumovirus; Flu A, influenza virus type A; ADV, adenovirus; Co-inf., co-infection.

• 

  Fig. 2 Monthly incidence of detected viruses from 2011 to 2012. RSV, respiratory syncytial virus; hRV, human rhinovirus; PIV, parainfluenza virus; hMPV, human metapneumovirus; Flu A, influenza virus type A; ADV, adenovirus.

• 

  Fig. 3 Distribution of clinical diagnosis according to the groups. RVP, respiratory virus positive; RVN, respiratory virus negative; URI, upper respiratory tract infection.

• 

  Fig. 4 Distribution of detected viruses according to the clinical diagnosis in respiratory virus positive group. RSV, respiratory syncytial virus; hRV, human rhinovirus; PIV, parainfluenza virus; hMPV, human metapneumovirus; Flu A, influenza virus type A; ADV, adenovirus; URI, upper respiratory tract infection.

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