Journal of the Korean Pediatric Society 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 Jeon1, Bong Seong Kim1, Yoo Kyum Kim2, Soo-Jong 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
소아에서 심한 급성 바이러스성 하기도 감염증에 대한 원인 및 임상양상(1998. 7-1999. 6)
전누리1, 김봉성1, 김유겸2, 홍수종1
1울산대학교 의과대학 서울중앙병원 소아과
2울산대학교 의과대학 미생물학교실
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.
Key Words: Respiratory tract infection, Respiratory syncytial virus, Influenza virus, Parainfluenza virus, Adenovirus


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