All issues > Volume 53(3); 2010

Original Article

Korean J Pediatr. 2010;53(3):380-391. Published online March 15, 2010.

Respiratory syncytial virus infection cases in congenital heart disease patients

Woo Sup WS Shim¹, Jae Yeong JY Lee², Jin Yong JY Song¹, Soo Jin SJ Kim¹, Sung Hye SH Kim¹, So Ick SI Jang¹, Eun Yong EY Choi¹

¹Department of Pediatrics, Sejong Hospital, Bucheon, Gyunggido, Korea
²Department of Pediatrics, Division of pediatric Cardiology, Seoul St. Mary`s Hospital, Seoul, Korea

Correspondence Woo Sup WS Shim ,Email: wsshim01@gmail.com

Received: October 28, 2009; Revised: January 12, 2010   Accepted: March 2, 2010.

Abstract

Purpose
: Respiratory syncytial virus (RSV) is one of the main pathogens causing lower respiratory infections (LRI) in young children, usually of limited severity. However, in congenital heart disease (CHD) patients, one of the high-risk groups for RSV infection, RSV can cause serious illnesses and fatal results. To elucidate the effects of RSV infection in CHD patients, we observed RSV infection cases among CHD patients and non-CHD patients.
Methods
: On admission of 343 LRI patients over 3 years, 77 cases of RSV infection were detected by the RSV antigen rapid test of nasopharyngeal secretion. We compared RSV infection cases among groups of CHD and non-CHD patients.
Results
: During the winter season, RSV caused 20–50% of LRI admissions in children. In patients with completely repaired simple left to right (L–R) shunt diseases such as ventricular septal defect, atrial septal defect, and patent ductus arteriosus, RSV infections required short admission days similar to non-CHD patients. In patients with repaired CHD other than simple L–R shunt CHD, for whom some significant hemodynamic problems remained, RSV infection required long admission days with severe clinical course. In children with unrepaired CHD, RSV infection mostly occurred in early infant age, with long admission days. RSV infections within a month after cardiac surgery also required long admission days and severe clinical course.
Conclusion
: To avoid the tragedic outcome of severe RSV infection in the CHD patients, efforts to find the subgroups of CHD patients at high risk to RSV infection are needed, and effective preventive treatment should be applied.

Keywords :Respiratory syncytial virus (RSV), Bronchiolitis, Pneumonia, Congenital heart defects/disease, Palivizumab