Korean J Pediatr Infect Dis.  1996 Nov;3(2):154-162. 10.14776/kjpid.1996.3.2.154.

Clinical Review of Pediatric Adenoviral Lower Respiratory Infection

• Son JA
• Lee SI
• Lee NY
• Kim JH

• KMID: 2440438
• DOI: http://doi.org/10.14776/kjpid.1996.3.2.154

Abstract

PURPOSE
Adenoviruses(Ad) have been shown to play an important role in the etiology of severely acute respiratory diseases, particulary in infants and young children, and the occurrence of fatal outcome and chronic pulmonary sequelae in association with adenoviral infection has been a cause of great interest and concern. This report presents the resul of a retrospective analysis on 30 cases of lower respiratory infection from which adenovirus was isolated. PATIENTS #SPCHAR_X0026; METHODS: The 30 patients in this study represent all detected cases of adenovial infection out of 240 children who were admitted to Sang Sung Medical Center between February to June 1996 showing signs and symptoms of lower respiratory tract infection. The diagnosis of adenovirus infection was based on microscopic visualization of typical cytopathic effect in HEp-2 tissue culture and used monoclonal Ab with nasopharyngeal aspiration.
RESULTS
The male/female ratio was 2:1 and the majority of age range was below 36months. Clinical diagnoses in all 30 patients were pneumonia(n=21), bronchitis and Bronchiolitis(n=5) and ARDS(n=4). We recieved the most of patients in the month of May. The chief complaints were fever(93.3%) and cough(80%) and extrapulmonary symptoms were diarrhea(n=5), seizure(n=4), abdominal pain(n= 1). The mean duration of fever was 11.95±6.546days. Physical examination on admission were crackles(73.3%), coarse breathing sounds(60%), hepatosplenomegaly(33.3%), decreased brething sounds(30%). In WBC counts, 8eases were below 4000/mm³and 14 cases were above 10,000/mm³. In platelets counts, 4cases were below 150,000/mm³ and 10 cases were above 450,000/mm³. 21 cases were above 1 in CRP. GOT and GPT were abnormal in some cases. Chest X-ray revealed diffuse pulmonary infiltration(n=15), pleural effusion(n=6), consolidation(n=4) and hyperaeration(n=3). Seven patients were treated at the peditric intensive care unit with respiratory support and high dose of gammaglobulin. However, one patients died even through he was treated with NO ventilation and high frequency ventilation.
CONCLUSION
Those with adenoviral pneumonia and respiratory infection having long fever duration and symptoms like bacterial pneumonia must be carefully differentiated in order to provide proper treatment and preventive measures due to possible fatal outcome.

MeSH Terms

Adenoviridae
Adenoviridae Infections
Bronchitis
Child
Diagnosis
Fatal Outcome
Fever
High-Frequency Ventilation
Humans
Infant
Intensive Care Units
Physical Examination
Pneumonia
Pneumonia, Bacterial
Respiration
Respiratory Tract Infections
Retrospective Studies
Thorax
Ventilation