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Etiology and Clinical Features of Viral Lower-respiratory Tract Infections in Children in Winter, 2003

Korean Journal of Pediatrics 2005;48(7):723-730.
Published online July 15, 2005.
Etiology and Clinical Features of Viral Lower-respiratory Tract Infections in Children in Winter, 2003
Byung Ho Yun, Hee Chul Lee, Jung Mi Chun, So Young Yoon, Woo Gill Lee, Son Moon Shin
Department of Pediatrics, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
2003년 겨울철 소아의 바이러스성 하기도 감염증에 대한 원인 및 바이러스별 임상양상
윤병호, 이희철, 천정미, 윤소영, 이우길, 신손문
성균관대학교 의과대학 삼성제일병원 소아과
Correspondence: 
So Young Yoon, Email: liobaped@hanmail.net
Abstract
Purpose
: This study was performed to characterize the etiology and clinical features of acute viral lower-respiratory tract infections(LRI).
Methods
: Etiologic agents and clinical features of acute viral LRI were studied from October. 2003 through March. 2004 in hospitalized children with LRI(253 cases) at Samsung Cheil Hospital. The viruses were identified by indirect immunofluorescent method. Medical records of patients with proven viral LRI were reviewed retrospectively.
Results
: Ninety two cases(36.4%) were confirmed as viral infections. The identified pathogens were respiratory syncytial virus(RSV, 76.0%), adenovirus(ADV, 12.0%), influenza virus type A(INFA, 9.8 %), influenza virus type B(INFB, 1.1%) and parainfluenza virus(PIV, 1.1%). Eight four point eight% of patients were younger than 2 years of age. Clinical diagnosis of LRI were pneumonia(56.5%), bronchiolitis(35.9%), tracheobronchitis(4.3%) and croup(3.3%). The clinical symptoms and signs were cough(98.8%), rhinorrhea(82.6%), fever(70.7%), rale(67.4%), wheezing(29.3%), chest retraction(28.3%) and cyanosis(4.3%). The severe respiratory symptoms and signs were more common in RSV-infected patients, even cyanosis could be observed. Seventeen point four percent of patient had fever of 38.5℃ or higher and their most common etiologic agent was INFA(66.7%). Twenty three point nine percent had fever more than 5 days and common etiologic agent was INFA(77.8%). The elevated WBC count(>14×103/ L) was in 14.1%, and common etiologic agents were INFA(22.2%) and ADV(18.2%). C-reactive protein(CRP >4.0 mg/dL) was increased in 13.0%, and common in ADV(63.6 %). Increased aspartate aminotransferase(AST)/alanine aminotransferase(ALT) was detected in 10.9%, and the most common etiologic agent was RSV(12.9%).
Conclusion
: The common agents of acute viral LRI were RSV, ADV and INF, respectively. Because the etiologic agents present variable clinical features, it may be helpful to treat and to evaluate acute viral LRI that we should understand their etiologic variability.
Key Words: Respiratory tract infections , Respiratory Syncytial virus , Adenovirus , Influenza virus type a , Influenza virus type b


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