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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
[Chest X-ray findings in children with enterovirus 71 infection]
Wei-Hua Zheng1, Xiong Li, Fang-Yuan Yang
1Department of Pediatrics, Affiliated Hospital of Guilin Medical College, Guilin, Guangxi 541001, China.
Insights
Chest X-ray findings in children with enterovirus 71 infection correlate with disease severity. Earlier and more frequent abnormalities on chest X-rays indicate a higher risk of severe or life-threatening enterovirus 71 disease.
Area of Science:
- Pediatric Infectious Diseases
- Radiology
- Viral Pathogenesis
Background:
- Enterovirus 71 (EV71) is a significant cause of hand, foot, and mouth disease, which can lead to severe neurological and respiratory complications in children.
- Chest X-ray imaging is a crucial diagnostic tool for assessing pulmonary involvement in pediatric infections.
Purpose of the Study:
- To characterize the chest X-ray findings in children diagnosed with enterovirus 71 infection.
- To correlate the timing and nature of chest X-ray abnormalities with the clinical severity of EV71 infection.
Main Methods:
- A retrospective study of 120 children with confirmed EV71 infection, categorized into mild, severe, and life-threatening groups.
- Analysis of the time from symptom onset to initial chest X-ray and the radiological findings in each group.
Main Results:
- The time to initial chest X-ray abnormalities was significantly shorter in severe (median 23 hrs) and life-threatening (median 19 hrs) groups compared to the mild group (median 37 hrs).
- Initial chest X-ray abnormality rates were 5.8% (mild), 81.3% (severe), and 100% (life-threatening), with significantly higher rates in severe and life-threatening cases.
- Radiological findings progressed from lung marking thickening (mild) to lung effusion/consolidation (severe) and pulmonary edema with widespread involvement (life-threatening).
Conclusions:
- The interval from symptom onset to chest X-ray, the timing of abnormality detection, abnormality rate, and severity of findings on chest X-ray are directly paralleled to the clinical status of children with EV71 infection.
- Chest X-ray findings can serve as an important indicator for predicting the clinical course and severity of enterovirus 71 infection in pediatric patients.
Objective:
To study the characteristics of the chest X-ray images in children infected with enterovirus 71.
Methods:
A total of 120 children with enterovirus 71 infection between April, 2010 and July, 2011 were classified into three groups according to the disease condition: mild (31 cases), severe (43 cases) and life-threatening (46 cases). The period from the onset of clinical symptoms to the first chest X-ray imaging examination and the results of the first chest X-ray findings were compared among the three groups.
Results:
The period from the onset of clinical symptoms to the first chest X-ray imaging examination in the mild, severe and life-threatening groups was 26-48 hrs (median 37 hrs), 10-36 h (median 23 hrs) and 2-36 hrs (median 19 hrs) respectively. Chest X-ray abnormalities were initially observed at 30 hrs after the onset of clinical symptoms in the mild group, at 23 hrs in the severe group and at 2 hrs in the life-threatening group (P<0.01). The mild group presented an initial imaging abnormality rate of 5.8%, the severe group 81.3% and the life-threatening group 100%. The life-threatening group showed a significantly higher initial X-ray abnormality rate than the other two groups (P<0.01). In terms of chest X-ray performance, the mild group usually presented lung marking thickening or vagueness. Most children in the severe group presented lung effusion and consolidation. Signs of pulmonary edema were found in the life-threatening group, and lesions in the life-threatening group were characterized by wide distribution and many lung lobe involvements.
Conclusions:
The interval between the onset of clinical symptoms and the initial chest X-ray examination, the period of time of, and the onset of clinical symptoms, at which chest X-ray abnormalities, the abnormality rate and the severity of chest X-ray findings may be paralleled to the clinical situation in children with enterovirus 71 infection.
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