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Rhinovirus infection associated with serious illness among pediatric patients
J A McMillan1, L B Weiner, A M Higgins
1Department of Pediatrics, SUNY Health Science Center, Syracuse.
Insights
Rhinovirus causes significant respiratory illness in infants, often leading to bronchiolitis and hospitalization. This study highlights rhinovirus as a key pathogen in young children, similar in severity to respiratory syncytial virus.
Area of Science:
- Pediatric infectious diseases
- Virology
- Respiratory medicine
Background:
- Rhinovirus is a common cause of respiratory infections, typically associated with upper respiratory tract infections.
- Its role in severe lower respiratory tract infections, particularly in infants, requires further elucidation.
Purpose of the Study:
- To investigate the clinical presentation and characteristics of rhinovirus infections in hospitalized and emergency room pediatric patients.
- To compare rhinovirus with other respiratory viruses like respiratory syncytial virus in terms of incidence and severity in young children.
Main Methods:
- Retrospective analysis of viral cultures from 48 pediatric patients with respiratory symptoms between July 1985 and December 1988.
- Clinical data, including diagnosis and treatment, were reviewed for all identified rhinovirus cases.
Main Results:
- Rhinovirus was identified in 48 pediatric patients, with 86% being under 12 months of age.
- Bronchiolitis was the most common diagnosis. Rhinovirus infection complicated underlying illnesses in 44% of hospitalized patients.
- Despite respiratory symptoms, 54% received antibacterial agents, often unnecessarily.
Conclusions:
- Rhinovirus is a significant cause of lower respiratory tract infections, including bronchiolitis, in infants.
- Rhinovirus infections in infants can be as severe as those caused by respiratory syncytial virus, necessitating appropriate diagnostic and treatment considerations.
Abstract:
Rhinovirus is an important cause of respiratory infection among all age groups, but it is primarily thought of as being responsible for upper respiratory tract infection. Rhinovirus was isolated from the respiratory tract of 48 pediatric patients who were hospitalized (40) or seen in a pediatric emergency room (8) during the period of July, 1985, through December, 1988. Twenty-eight (58%) of the patients presented during the spring and early summer. Forty-one (86%) of the 48 patients were less than 12 months of age. All except four of the patients had viral cultures performed because of respiratory symptoms. Bronchiolitis was the single most frequent clinical diagnosis and was noted in equal proportion among children less than 3 months and 3 to 12 months of age. Nine patients were assigned a diagnosis of suspected sepsis. Rhinovirus infection was a complication of underlying illness for 17 (44%) of the 40 hospitalized patients, and those patients tended to be older than the otherwise healthy hospitalized infants with rhinovirus. Twenty-six patients (54%) were treated with antibacterial agents, although only one patient was documented to have a concomitant bacterial infection (Chlamydia trachomatis). Overall rhinovirus isolation during the study period represented 0.7% of all specimens submitted for viral isolation compared with 8.2% for respiratory syncytial virus. Rhinovirus infection leads to hospitalization less frequently than does respiratory syncytial virus infection, but the severity of illness and clinical presentation in young infants are similar.