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Roentgenographic features of common pediatric viral respiratory tract infections
S R Wildin1, T Chonmaitree, L E Swischuk
1Department of Pediatrics, University of Texas Medical Branch, Galveston 77550.
Insights
Common viral respiratory infections in children show similar X-ray findings. Respiratory syncytial virus (RSV) infections lead to more abnormal chest X-rays than other viruses, especially in young infants.
Area of Science:
- Pediatric Pulmonology
- Pediatric Radiology
- Virology
Background:
- Viral respiratory infections are common in infants and children.
- Limited data exists on roentgenographic findings for common respiratory viruses beyond RSV.
- Chest X-rays are crucial for diagnosing lower respiratory tract infections in children.
Purpose of the Study:
- To investigate and compare roentgenographic findings in infants and children with common viral respiratory infections.
- To determine if non-RSV viral infections present similar radiographic patterns.
- To identify specific viral associations with radiographic findings and patient demographics.
Main Methods:
- Retrospective analysis of chest roentgenograms from 128 children with confirmed viral infections.
- Viruses studied included respiratory syncytial virus, parainfluenza virus, influenza virus, and adenovirus.
- Evaluation of common radiographic findings such as infiltrates, hyperexpansion, atelectasis, and adenopathy.
Main Results:
- Common findings included parahilar peribronchial infiltrates, hyperexpansion, atelectasis, and hilar adenopathy.
- Respiratory syncytial virus (RSV) infections were associated with more abnormal chest X-rays compared to other viruses.
- Adenovirus infections showed a higher prevalence of hilar adenopathy. Young infants had more abnormal findings, and lobar atelectasis correlated with illness severity.
Conclusions:
- Roentgenographic findings in common viral respiratory infections in children can mimic those of RSV.
- RSV infections tend to result in more significant radiographic abnormalities.
- Chest X-rays are valuable adjuncts for clinical diagnosis and management of viral lower respiratory tract infections in pediatric patients.
Abstract:
Viral infections of the respiratory tract in infants and children are common. Little has been reported on roentgenographic findings associated with infection caused by common viruses other than with respiratory syncytial virus. We studied chest roentgenograms from 128 previously healthy infants and children who were infected with respiratory syncytial virus, parainfluenza virus, influenza virus, or adenovirus. Four common roentgenographic findings were detected: parahilar peribronchial infiltrates, hyperexpansion, segmental or lobar atelectasis, and hilar adenopathy. Diffuse interstitial infiltrates and significant pleural fluid accumulations rarely occurred in our series. We confirmed the popular but not well-documented belief that other common respiratory viruses can be associated with roentgenographic findings similar to those caused by respiratory syncytial virus. However, respiratory syncytial virus infection is associated with more abnormal chest roentgenograms than any of the other viruses regardless of the clinical syndrome. Hilar adenopathy was more common in adenovirus infection. Young infants had significantly more abnormal chest roentgenograms, with more hyperexpansion and parahilar peribronchial infiltration than older children. We also found a significant correlation between lobar atelectasis and severity of the illness. In infants and children with viral infection of the lower respiratory tract, roentgenographic information can be a useful adjunct to clinical viral diagnosis.