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Etiology and Clinical Features of Acute Viral Lower Respiratory Tract Infection in Apparently Healthy children

Journal of the Korean Pediatric Society 1996;39(12):1690-1699.
Published online December 15, 1996.
Etiology and Clinical Features of Acute Viral Lower Respiratory Tract Infection in Apparently Healthy children
Song Yi Nah, Jeong Yun Hong, Eun Hwa Choi, , Hoan Jong Lee
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
소아의 급성 바이러스성 하기도 감염증의 원인 및 임상상
나송이, 홍정연, 최은화, 윤보영, 이환종
서울대학교 의과대학 소아과학교실
Abstract
Purpose
: Acute lower respiratory tract infections(LRIs) are an important cause of pediatric morbidity and mortality. Causes of acute LRI in infants and children include bacteria, mycoplasma and respiratory viruses. Understanding of the epidemiology, etiology and clinical features of acute viral LRI is essential to improve the methods of prevention, diagnosis and management of these infections.
Methods
: Viral etiologic agents and clinical features of acute viral LRI were studied from November 1990 through April 1994 in apparently healthy children. Nasal aspirates were collected from 334 children, who visited or admitted to Seoul National University Hospital due to acute LRI. Viral agents were detected by virus isolation and/or antigen detection by indirect immunofluorescent staining. Medical records of children with proven viral LRIs were reviewe retrospectively.
Results
: 1) One or more viral agents were identified in 162 cases(48.45%). 2) The pathogens identified were RSV(54.6%), adenovirus(12.8%), parainfluenza virus type 3(12.1%), influenza A virus(8.5%), parainfluenza virus type 1(5.7%), influenza B virus(1.4%), parainfluenza type 2(1.4%) and mixed(two) viruses(3.5%). 3) Mean age was 15 months and acute viral LRIs occurred mostly in the first two years of life(82%). 4) Clinical patterns of viral LRI were pneumonia(45%), bronchiolitis(32%), croup(13%) and tracheobronchitis(2.1%). 5) Forty-three percents of febrile patients had fever of 39℃ or more and 44.5% had fever for 5 days or more. 6) Leukocytosis and increased CRP(more than 3+) were detected in 23% and 16%, respectively. 7) The major radiologic features are parahilar peribronchial infiltration, overaeration and consolidation.
Conclusion
: We studied the etiologic agents and clinical features of acute viral LRI in apparently healthy children, the results of which may be helpful to the clinicians and further studies are needed for prevention and treatment of acute viral LRI.
Key Words: Respiratory infection, Respiratory syncytial virus, Adenovirus, Influenza virus, Parainfluenza virus


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