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Pediatric adenovirus pneumonia: clinical practice and current treatment

Jie Zhang1, Yiting Zhu1, Yiyang Zhou1

  • 1Department of Pediatrics, The Second School of Medicine, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.

Frontiers in Medicine
|July 21, 2023
PubMed

Insights

Severe pediatric adenovirus pneumonia, a common respiratory infection, has high mortality and sequelae. Early recognition and management are crucial, as viral load impacts prognosis.

Area of Science:

  • Pediatric Infectious Diseases
  • Respiratory Medicine
  • Virology

Background:

  • Adenovirus pneumonia is a frequent pediatric upper respiratory tract infection with a high risk of severe outcomes and mortality.
  • Adenoviruses cause direct cellular damage and trigger immune responses, complicating the infection.
  • Current treatments lack specificity, necessitating supportive care and management of complications.

Purpose of the Study:

  • To review the pathogenesis, early recognition, and therapeutic strategies for severe pediatric adenovirus pneumonia.
  • To identify risk factors associated with poor outcomes, including post-infectious bronchiolitis obliterans (PIBO) and death.
  • To highlight the significance of viral load and serological identification in assessing severity and prognosis.

Main Methods:

  • Review of current literature on adenovirus pneumonia in children.
  • Analysis of clinical symptoms, laboratory tests, and imaging findings for early recognition.
  • Evaluation of treatment modalities including antiviral drugs, respiratory support, and immunomodulatory therapy.
  • Identification of risk factors for severe disease, PIBO, and mortality.

Main Results:

  • Early recognition involves specific symptoms (dyspnea, toxic symptoms), CT findings (atelectasis), and elevated inflammatory markers (CRP, PCT) in young children.
  • Key complications include PIBO and hemophagocytic syndrome; risk factors for PIBO include mechanical ventilation, steroid use, fever duration, and male gender.
  • Factors associated with mortality include hypoxemia, hypercapnia, mechanical ventilation, and low albumin levels.
  • Viral load and serological identification are critical for diagnosis and prognosis.

Conclusions:

  • Effective management of severe pediatric adenovirus pneumonia requires prompt recognition and supportive care.
  • Identifying and mitigating risk factors for PIBO and mortality is essential for improving patient outcomes.
  • Viral load serves as a crucial indicator for disease severity and prognosis in adenovirus pneumonia.

Keywords:
early recognitionpediatricprognosissevere adenovirus pneumoniatherapy

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