Respiratory viral infections in infants with clinically suspected pertussis

Objectiveto evaluate the frequency of respiratory viral infections in hospitalized infants with clinical suspicion of pertussis, and to analyze their characteristics at hospital admission and clinical outcomes.Methodsa historical cohort study was performed in a reference service for pertussis, in which the research of respiratory viruses was also a routine for infants hospitalized with respiratory problems. All infants reported as suspected cases of pertussis were included. Tests for Bordetella pertussis (BP) (polymerase chain reaction/culture) and for respiratory viruses (RVs) (immunofluorescence) were performed. Patients who received macrolides before hospitalization were excluded. Clinical data were obtained from medical records.ResultsAmong the 67 patients studied, BP tests were positive in 44%, and 26% were positive for RV. There was no etiological identification in 35%, and RV combined with BP was identified in 5%. All patients had similar demographic characteristics. Cough followed by inspiratory stridor or cyanosis was a strong predictor of pertussis, as well as prominent leukocytosis and lymphocytosis. Rhinorrhea and dyspnea were more frequent in viral infections. Macrolides were discontinued in 40% of patients who tested positive for RV and negative for BP.Conclusionthe results suggest that viral infection can be present in hospitalized infants with clinical suspicion of pertussis, and etiological tests may enable a reduction in the use of macrolides in some cases. However, the etiological diagnosis of respiratory virus infection, by itself, does not exclude the possibility of infection with BP.     

Respiratory syncitial virus in children with acute respiratory infections

Objective  

To study the nutritional status of children with Respiratory Syncitial virus infection.     

Herpesvirus infections in children with acute lymphatic leukemia

33 children with acute lymphatic leukemia and 33 healthy controls were longitudinally studied for herpesvirus infections. Active herpes simplex-virus, varicella-zoster virus and cytomegalovirus (CMV) infections were more frequent in patients than in controls. CMV and Epstein-Barr virus infections were often inapparent or associated with infections of the upper respiratory tract. Analysis of serological datas revealed a coincidence of active CVM infection and lethal course of the leukemia. This may be a result of the immunodeficiency in leukemia patients caused by disease and therapy. An additional influence of the immunosuppressive effect of active CMV infections on the course of the disease is discussed.     

Mixed bacterial-viral infections in septic children with leukemia

BACKGROUND: Febrile infections in children with leukemia are common. The occurrence of possible mixed bacterial-viral infections is unknown. METHODS: We searched for viruses in leukemic children with blood culture-positive bacterial infections. The prospective multicenter survey included 156 febrile episodes in 51 children with acute leukemia. The mean follow-up time was 1.5 years per patient (27,743 patient-days at risk). Sixteen viruses were searched for from nasal swab and stool samples using virus culture, virus antigen detection, and polymerase chain reaction tests. RESULTS: Bacterial blood cultures were positive in 19 (11%) febrile episodes among 17 children. In half of the septic episodes (11 of 19), a virus was also found. Rhinovirus and respiratory syncytial virus were the most common viruses detected. CONCLUSIONS: Our findings suggest that invasive bacterial infections are commonly associated with viral infections in children with leukemia.     

Respiratory virus infections in children with cancer or HIV infection

Most studies focusing on respiratory infections in immunocompromised children have been addressed to bacterial etiology. However, respiratory virus infections in this population can also lead to severe disease. The objective of this study is to evaluate the clinical significance of respiratory virus infections in children with cancer or human immunodeficiency virus (HIV) infection.Retrospective study conducted in a teaching hospital in Madrid. Medical records from children 相似文献   

Respiratory tract infections in children in developing countries

Acute respiratory infections are the main cause of morbidity worldwide, and pneumonia represents one of the main causes of death in children younger than the age of 5 years in developing countries. Several risk factors for acquiring respiratory infections in developing countries, such as poverty, restricted family income, low parental education level, low birth weight, malnutrition, and lack of breastfeeding, have been described. Another important factor in recent years that has aggravated the problem of acute respiratory infections in developing countries is the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pandemic. In developing countries, identifying the etiology is difficult and World Health Organization recommends making the diagnosis of pneumonia based on clinical parameters. The diagnosis and suitable treatment administered by primary healthcare workers, particularly in rural areas, is part of the strategy to prevent mortality. Finally, it is important that industrialized countries support the economic growth of the developing countries to improve their healthcare system and to ensure that performed research studies will give benefits to their populations.     

Respiratory tract infections in children with recurrent episodes as preschoolers.

The occurrence of respiratory tract infections (RTI) in 41 school-age children, who had recurrent RTIs treated with antibiotics as preschoolers, was followed prospectively for two years through diary reports by parents and medical consultations, and compared with that in 29 children of the same age and socio-economic background, who had few or no such infections as preschoolers. During the two-year follow-up, a greater number of episodes of RTI and a longer mean duration of such episodes were reported in the diaries concerning the children with recurrent bacterial RTIs as preschoolers compared with the controls (p less than 0.01). The annual incidence of bacterial RTI from birth onwards decreased with age among the children with recurrent episodes as preschoolers, unlike in the control group, where the incidence remained consistently low, the difference in incidence being significant up to the age of eight years (p less than 0.01). Acute otitis media was the predominant bacterial RTI in preschoolers, and acute tonsillitis in school-age children. There was a tendency toward a greater incidence of other types of disease and complications/sequelae of infections among the RTI-afflicted group than among the controls, both as preschoolers and as school children. Our findings suggest that certain children constitute a group with high morbidity, susceptible to RTIs and other illnesses over a rather long period of years.     

Respiratory viral infection in lower airways of asymptomatic children

Aim: The aim of this study was to determine if asthmatic children have viruses more commonly detected in lower airways during asymptomatic periods than normal children. Methods: Fifty‐five asymptomatic children attending elective surgical procedures (14 with stable asthma, 41 normal controls) underwent non‐bronchoscopic bronchoalveolar lavage. Differential cell count and PCR for 13 common viruses were performed. Results: Nineteen (35%) children were positive for at least one virus, with adenovirus being most common. No differences in the proportion of viruses detected were seen between asthmatic and normal ‘control’ children. Viruses other than adenovirus were associated with higher neutrophil counts, suggesting that they caused an inflammatory response in both asthmatics and controls (median BAL neutrophil count, 6.9% for virus detected vs. 1.5% for virus not detected, p = 0.03). Conclusions: Over one‐third of asymptomatic children have a detectable virus (most commonly adenovirus) in the lower airway; however, this was not more common in asthmatics. Viruses other than adenovirus were associated with elevated neutrophils suggesting that viral infection can be present during relatively asymptomatic periods in asthmatic children.