The viral factor in the etiology of acute asthma attacks in children

Over the last decade firm proponents of a viral etiology have risen, alongside those considering mycoplasma as prime agent in the induction of bronchospasm. Since we are not convinced as to the validity of the viral hypothesis, we decided to study a group of asthmatics to detect the different viral antigens serologically, in order to determine which can play a decisive role in the pathogenesis of the asthmatic crisis. Without previous etiologic selection, 37 children admitted as emergency cases with severe asthmatic crises, were chosen for the study. All were being treated as asthmatics and were diagnosed as bacterial or mixed asthmatics according to the Ciba Symposium criteria; the ages ranged from one to eleven years. Four patients presented infections by RS virus and of these, two showed an accompanying infection by Coxsackie B3 and B5. Only one patient presented antibodies against mycoplasma pneumoniae. The incidence of maxillary sinusitis was 75.6%. We found the only 13.5% of the children showed specific antibodies, against any of the 16 viral antigens tested. That is, we find that in parallel with the bacterial infection, there exists a viral infection which is manifested by the increment of specific antibody titers after ten days. The asthmatic symptoms disappeared after antibiotic and corticoid therapy, as opposed to the resistance to this form of treatment reported by McIntosh.