All issues > Volume 43(12); 2000

Original Article

J Korean Pediatr Soc. 2000;43(12):1558-1568. Published online December 15, 2000.

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

Noo Lee NL Jeon¹, Bong Seong BS Kim¹, Yoo Kyum YK Kim², Soo-Jong SJ Hong¹

¹Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
²Department of Microbiology, College of Medicine, University of Ulsan, Seoul, Korea

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 38.5℃ 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.

Keywords :Respiratory tract infection, Respiratory syncytial virus, Influenza virus, Parainfluenza virus, Adenovirus