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Serious respiratory illness associated with rhinovirus infection in a pediatric population
1Department of Pediatrics, Children's Hospital of Philadelphia and School of Medicine, University of Pennsylvania 19104, USA.
Insights
Rhinoviruses (RV) can cause severe lower respiratory illness in children, leading to hospitalization. RV infections are particularly serious for infants and children with pre-existing health conditions.
Area of Science:
- Pediatric infectious diseases
- Viral respiratory pathogens
- Public health
Background:
- Rhinoviruses (RV) are commonly linked to mild upper respiratory illness.
- Their role as lower respiratory tract pathogens, especially in infants, requires further characterization.
- Previous data suggests RV may cause severe lower respiratory illness in young children.
Purpose of the Study:
- To describe the clinical presentations, illness severity, and outcomes of pediatric patients with documented RV infections.
- To analyze a large cohort of children hospitalized with RV infections.
Main Methods:
- Retrospective chart review of 93 pediatric patients with 101 positive RV specimens.
- Data collected from The Children's Hospital of Philadelphia between January 1990 and May 1996.
- Included patients from emergency department visits and hospital admissions.
Main Results:
- 84% of patients presented with acute respiratory illness.
- 69% had significant past medical histories, including prematurity, reactive airways, and congenital heart disease.
- The mean hospitalization duration for respiratory illness was 3.7 days.
Conclusions:
- Rhinoviruses are associated with severe lower respiratory illness and hospitalization in pediatric populations.
- RV infection can complicate the health of children with underlying or predisposing conditions.
- RV should be considered a significant pathogen in pediatric respiratory infections.
Background:
Rhinoviruses have long been associated with mild upper respiratory illness in both adults and children. However, the role of rhinoviruses as lower respiratory tract pathogens has not been fully characterized. Previous data suggests that rhinoviruses may cause severe lower respiratory illness in young children or infants.
Objectives:
The present study describes the clinical presentations, severity of illness and outcomes for a large cohort of pediatric patients with documented rhinovirus infections.
Subjects And Methods:
A retrospective chart review was done on 93 pediatric patients from whom 101 nasopharyngeal or endotracheal specimens were positive by viral culture for a rhinovirus. All patients were hospitalized or seen in the pediatric emergency department at The Children's Hospital of Philadelphia between 1 January, 1990 and 31 May, 1996.
Results:
Of the 93 patients, 52 were male and 41 female. The age range was 0 days to 18 years with 25 (27%) less than 3 months, 42 (45%) between 3 and 12 months and 26 (28%) over the age of 12 months. Clinical presentations on evaluation in the emergency department or admission included 78 (84%) patients with acute respiratory illness, 13 (17%) with fever and suspected sepsis and 11 (12%) with other complaints. Reported physical findings on examination included one or more lower respiratory symptoms or signs of acute distress and fever greater than or equal to 38.1 degrees C. A total of 64 (69%) children were noted to have significant past medical histories, including 28 (44%) with prematurity or complicated neonatal courses, 11 (17%) with prior reactive airways, 8 (12%) with congenital cardiac disease and 7 (11%) with neurologic disorders. Of the patients, 29 (31%) were considered to be otherwise healthy children with no underlying dysfunctions. The mean duration of hospitalization for 69 patients admitted with respiratory illness who did not develop subsequent unrelated complications was 3.7 days. No significant bacterial or fungal pathogens were identified in 91% of the cases.
Conclusions:
This study shows that rhinoviruses were associated with severe lower respiratory illness and hospitalization in a large pediatric population and that rhinovirus infection was a complicating factor in those patients with underlying or predisposing conditions.