Korean Journal of Pediatrics 2010;53(3):380-391.
Published online March 15, 2010.
Respiratory syncytial virus infection cases in congenital heart disease patients
Woo Sup Shim1, Jae Yeong Lee2, Jin Yong Song1, Soo Jin Kim1, Sung Hye Kim1, So Ick Jang1, Eun Yong Choi1
1Department of Pediatrics, Sejong Hospital, Bucheon, Gyunggido, Korea
2Department of Pediatrics, Division of pediatric Cardiology, Seoul St. Mary`s Hospital, Seoul, Korea
선천성심장병 환아에서의 Respiratory syncytial virus 감염례 관찰
심우섭1, 이재영2, 송진영1, 김수진1, 김성혜1, 장소익1, 최은영1
1부천세종병원 소아청소년과
2부천세종병원 소아청소년과
Correspondence: 
Woo Sup Shim, Email: wsshim01@gmail.com
Received: 28 October 2009   • Revised: 12 January 2010   • Accepted: 2 March 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.
Key Words: Respiratory syncytial virus (RSV), Bronchiolitis, Pneumonia, Congenital heart defects/disease, Palivizumab


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