Viral Infection of the Lower Respiratory Tract

1987 ◽  
Vol 8 (3) ◽  
pp. 405-418
Author(s):  
Richard M. Rose ◽  
Paula Pinkston ◽  
Carl O’Donnell ◽  
William A. Jensen
Keyword(s):  
Respiratory Tract ◽  
Viral Infection ◽  
Lower Respiratory Tract

Acute Lower Respiratory Tract Illnesses in Cali, Colombia: A Two-Year Ambulatory Study

PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 210-218
Author(s):  
Stephen Berman ◽  
Alvaro Duenas ◽  
Alvaro Bedoya ◽  
Victor Constain ◽  
Saul Leon ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Viral Infection ◽  
Lower Respiratory Tract ◽  
Influenza Viruses ◽  
High Fever ◽  
Severe Malnutrition ◽  
Viral Agent ◽  
Respiratory Tract Illnesses ◽  
Syncytial Virus ◽  
Tract Infections

A surveillance system for acute lower respiratory tract illnesses was implemented February 1977 in five neighborhood health clinics. Of the 1,229 patients with an illness identified during the 25 months from Feb 1, 1977 to Feb 28, 1979, there were 38 with croup, 451 with tracheobronchitis, 339 with bronchiolitis, and 401 with pneumonia. Forty-two percent of the illnesses occurred in children less than 1 year of age and 66% occurred in children less than 2 years of age. A viral infection was diagnosed in 20% of the patients by viral cultures and/or fourfold rises in complement fixation antibody titers in acute and convalescent sera. A viral agent was identified in 29% of patients with croup, 20% with tracheobronchitis, 22% with bronchiolitis, and 17% with pneumonia. Four viral agents, respiratory syncytial virus (RSV) adenovirus, parainfluenza viruses, and influenza viruses accounted for 94% of the cases associated with a viral infection. RSV was associated with 9% of the cases, adenovirus with 6.8%, parainfluenza with 2.1%, and influenza with 1.3%. These four viral agents had slightly different clinical patterns. The majority of RSV infections were diagnosed in children less than 2 years of age with bronchiolitis or pneumonia. Yearly outbreaks of RSV were noted during periods corresponding to RSV peaks in northern temperate climates. Adenoviral infections occurred most frequently in children between 1 and 5 years of age with tracheobronchitis or pneumonia in association with high fever. Parainfluenza viral infections were usually associated with tracheobronchitis and pneumonia. Influenza infections usually occurred in older children with pneumonia associated with high fever, headache, and myalgias. Bacteremias were identified in four patients with lower respiratory tract infections. Twenty percent of children with moderate or severe malnutrition and an acute respiratory illness were bacteremic. Three of the four children with moderate or severe malnutrition, pneumonia, and fever greater than 38.9°C had a positive blood culture. There were 17 children seen who required hospitalization and three subsequent deaths in this group.

scholarly journals THE IMPORTANCE OF VIRAL ETIOLOGY DETERMINATION IN SEVERE LOWER RESPIRATORY TRACT INFECTIONS IN INFANTS AND CHILDREN

2015 ◽  
Vol 64 (2) ◽  
pp. 140-144
Author(s):  
Alexandru-Ioan Ulmeanu ◽  
◽  
Carmen Zapucioiu ◽  
Maria Dorina Craciun ◽  
Coriolan Ulmeanu ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Viral Infection ◽  
Lower Respiratory Tract ◽  
Viral Etiology ◽  
Viral Detection ◽  
Infection Group ◽  
Young Infants ◽  
Tract Infections ◽  
The Impact ◽  
Children Under 5

Introduction. Community-acquired pneumonia is one of the leading causes of death worldwide in children under 5 years. In practice, viral detection using multiplex PCR is becoming increasingly used, it is most useful to understand the epidemiology and impact of viruses on the pediatric population but there are still many debates regarding the influence of viral detection on patient care. Objectives. In this study we aimed to analyze the impact of viral etiology determination on the duration of hospitalization and on the administered treatment. Material and methods. The selection criteria was: children between 0-5 years with severe lower respiratory tract infection. We have analyzed three groups of patients: a group with specified viral infection, a second group with unspecified viral infection and a third group with bacterial infection. Results. In the analyzed period 72 children under 5 years of age who have shown signs of acute respiratory failure have been diagnosed with a specific viral infection, only 2% of the total viral infections. The main etiology was represented by respiratory syncytial virus (RSV) in 73.5% of cases, followed by Influenza 11%, Parainfluenza 4.2%, metapneumovirus (hMPV), Rhinovirus, Adenovirus and Bocavirus all with 2.8%. Within the unspecified viral infection group antibiotics were used in 85.5% (n = 53) of the cases. Within the specified viral infection group although viral etiology was firmly established antibiotics usage rate was higher 92% (n = 57). Duration of hospital stay was 2,5 days higher in the viral specified group compared with the unspecified one. Thus we found that although the diagnosis of viral infection was certainly given because of severe clinical picture and young age of children the expenses were 30% higher. Conclusions. In our study, RSV is the most common virus involved in the etiology of viral LRTI and is encountered in the most severe forms of the disease especially in young infants and prematures. Antibiotics are commonly used in the severe forms of LRTI, even if the viral etiology is certain and the groups of antibiotics used are similar. Determination of viral etiology has not reduced hospitalization, nor has led to changing of physician therapeutic approach.

scholarly journals 1348. A Novel Host-Protein Signature Comprising TRAIL, IP-10 and CRP Differentiates Bacterial from Viral Infection in COPD Patients with Suspected Lower Respiratory Tract Infection

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S761-S761
Author(s):  
Salim Halabi ◽  
Shachaf Shiber ◽  
Michal Stein ◽  
Meital Paz ◽  
Tanya Gottlieb ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Viral Infection ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Board Member ◽  
Host Protein ◽  
Reference Standard ◽  
Copd Patients

Abstract Background Identifying infectious etiology is often challenging, yet essential for patient management, including antibiotic use. Studies have shown that a host signature comprising TNF-related apoptosis induced ligand (TRAIL), interferon gamma induced protein-10 (IP-10) and C-reactive protein (CRP) accurately differentiates bacterial from viral infection with negative predictive value >98%. Performance data was lacking in chronic obstructive pulmonary disease (COPD) patients with suspected lower respiratory tract infection (LRTI). Methods Adults aged >18 years with suspected LRTI were prospectively recruited at 3 medical centers (OBSERVER; grant #684589; NCT003011515). Reference standard infection etiology was adjudicated by 3 independent experts based on clinical, laboratory, microbiological, radiological and follow-up data. Host signature generates a bacterial likelihood score (0-100), providing three results: viral (0-35), equivocal (35-65) and bacterial (65-100). Experts were blinded to the signature result. Results Out of 583 adults recruited with suspected LRTI, 422 met infectious criteria, of whom 48 had a recorded history of COPD. 19 cases were adjudicated by the experts as bacterial, 14 as viral and 15 were indeterminate (Figure 1). The mean age was 68.2 years (standard deviation 12.3); 33 (68.8%) presented after two or more days of symptoms and 38 (79.2%) were hospitalized for a median of 6 days. 15 (31.2%) were female. For the patients adjudicated bacterial or viral labels (n=33), the discharge diagnoses were: COPD exacerbation, 12 cases (36.4%); pneumonia, 12 cases (36.4%) (3.0%); acute bronchitis, 2 cases (6.1%); upper RTI ,1 case; unspecified viral infection 1 case (3.0%); or other, 5 cases (15.2%). Host signature correctly classified all 19 bacterial cases and 8 of the viral cases, providing accurate etiology labels for 27/33 COPD patients with reference standard labels (81.8%). The remaining 6 viral cases received equivocal scores (18.2%). COPD patient enrollment and etiology labels in the Observer study Conclusion Host signature accurately differentiates between bacterial and viral infections in patients with COPD history, supporting potential to improve management among these patients frequently admitted for RTIs. Disclosures Michal Stein, MeMed (Employee) Meital Paz, MD, MeMed (Employee) Tanya Gottlieb, PhD, MeMed (Employee, Shareholder) Eran Barash, MA, MeMed (Employee) Roy Navon, MSc, MeMed (Employee, Shareholder) Einat Moscoviz, BSc+ MBA, MeMed (Employee) Tahel Ilan Ber, MD, MeMed (Employee, Shareholder) Liran Shani, MD, MeMed (Employee) Olga Boico, PhD, MeMed (Employee) Einav Simon, PhD, MeMed (Employee, Shareholder) Noa Avni, PhD, MeMed (Employee) Kfir Oved, MD, PhD, MeMed (Board Member, Employee, Shareholder) Eran Eden, PhD, MeMed (Board Member, Employee, Shareholder)

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