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Updated: Nov 20, 2025

Remote Laboratory Management: Respiratory Virus Diagnostics
Published on: April 6, 2019
Prevalence of Bandemia in Respiratory Viral Infections: A Pediatric Emergency Room Experience
Estela Noyola1, Asif Noor1, Nicole Sweeney1
1Department of Pediatrics, NYU Long Island School of Medicine, Mineola, NY, United States.
Insights
Bandemia, indicated by band neutrophils, is common in febrile children with respiratory viral infections, especially in early stages. This finding is crucial for diagnosing pediatric viral illnesses.
Area of Science:
- Pediatric Infectious Diseases
- Hematology
- Clinical Microbiology
Background:
- Febrile infants and children frequently present to emergency departments.
- Distinguishing viral from bacterial infections is critical for appropriate treatment.
- Bandemia, an increase in immature neutrophils, can be a marker of infection.
Purpose of the Study:
- To determine the prevalence of bandemia in children with confirmed respiratory viral infections.
- To analyze bandemia rates across different types of respiratory viruses.
- To assess the diagnostic utility of bandemia in pediatric febrile illnesses.
Main Methods:
- Observational retrospective study.
- Included febrile children aged 1 month to 5 years with confirmed viral respiratory infections.
- Excluded patients with evidence of bacterial coinfection.
Main Results:
- 419 patients with viral infections were analyzed.
- High prevalence of bandemia observed in adenovirus, RSV, hMPV, and parainfluenza virus infections.
- Bandemia rates varied significantly based on viral type and cutoff threshold (5% vs. 10%).
Conclusions:
- Band neutrophils are frequently detected in children with confirmed respiratory viral infections.
- The presence of bandemia is particularly notable during the early stages of these infections.
- Findings suggest bandemia can be a relevant indicator in pediatric viral respiratory illness.
Abstract:
Objective: The aim of this study was to examine the prevalence of bandemia in confirmed respiratory viral infections in febrile infants and children presenting to the emergency department. Methods: An observational retrospective study from January 1, 2016, through December 31, 2016, was conducted in patients between the ages of ≥ 1 month and ≤ 5 years presenting to the emergency room with fever and who had a complete blood cell count performed. Patients were separated into seven groups based on the type of respiratory viral infection. Inclusion criteria strictly counted children with viral infections and absence of clinical and laboratory evidence of a bacterial coinfection. Results: A total of 419 patients had a documented viral infection. A significant proportion of these children were found to have bandemia; children with adenovirus (17%), respiratory syncytial virus (RSV) (14.9%), human metapneumovirus (hMPV) (13%), and parainfluenza virus (7.9%) had the highest prevalence when the cutoff for bandemia was set at 10%. The prevalence increased to 35.3, 30.9, 40.3, and 15.8% for adenovirus, RSV, hMPV, and parainfluenza virus, respectively, when this cutoff was lowered further to 5%. Conclusion: Band neutrophils are detected frequently in confirmed respiratory viral infections particularly during early stages.
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