scholarly journals Is Fever a Red Flag for Bacterial Pneumonia in Children With Viral Bronchiolitis?

2019 ◽  
Vol 6 ◽  
pp. 2333794X1986866 ◽  
Author(s):  
Dominique Elmore ◽  
Balfaqih Yaslam ◽  
Krista Putty ◽  
Thomas Magrane ◽  
Anthony Abadir ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Respiratory Syncytial Virus ◽  
Early Diagnosis ◽  
Respiratory Infection ◽  
Bacterial Pneumonia ◽  
Upper Respiratory Infection ◽  
Red Flag ◽  
Upper Respiratory ◽  
Syncytial Virus ◽  
Secondary Bacterial Pneumonia

We hypothesized that fever in children with viral bronchiolitis indicates the need for consideration of superimposed bacterial pneumonia. We conducted a retrospective study of 349 children aged 2 years and younger with diagnoses of respiratory syncytial virus (RSV) and viral upper respiratory infection. Data were analyzed using Pearson χ2 test. One hundred seventy-eight children had RSV with no other identified virus. The majority of children (56%) who had only RSV were afebrile. Febrile children with RSV were over twice as likely to be diagnosed with bacterial pneumonia as those who were afebrile (60% vs 27%, P < .001). In the 171 children who had bronchiolitis caused by a virus other than RSV, 51% were afebrile. These children were 8 times more likely to be diagnosed with pneumonia than those who were afebrile (65% vs 8%, P < .001). Evaluation of febrile children with viral bronchiolitis may allow early diagnosis and treatment of secondary bacterial pneumonia.

Shortness of Breath

2018 ◽  
pp. 300-303
Author(s):  
Sylvia E. Garcia
Keyword(s):  
Respiratory Syncytial Virus ◽  
Supportive Care ◽  
Small Subset ◽  
Shortness Of Breath ◽  
Upper Respiratory Infection ◽  
Bronchodilator Therapy ◽  
Panel Testing ◽  
Upper Respiratory ◽  
Lower Airways ◽  
Syncytial Virus

This case illustrates the classic presentation of bronchiolitis, which is a clinical diagnosis. The pathophysiology is that of an upper respiratory infection, most commonly respiratory syncytial virus, progressing to involve the lower airways, with subsequent wheezing and respiratory distress. Supportive care is the focus of management in the majority of cases, as interventions including bronchodilators, nebulized racemic epinephrine, nebulized hypertonic saline (for nonhospitalized settings), steroids, and antibiotics all provide inconsistent or no benefit. Although a small subset of patients has shown to benefit from bronchodilator therapy, no study clearly defines this group. In severe cases, noninvasive respiratory support may be needed. Radiographic imaging and respiratory panel testing for infectious causes are not routinely recommended.

Influence of Previous Respiratory Infection on the Association between Respiratory Syncytial Virus Hospitalization and Childhood Asthma

2020 ◽  
Author(s):  
Richard Thwaites ◽  
Jonathan Coutts ◽  
John Fullarton ◽  
ElizaBeth Grubb ◽  
Carole Morris ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Respiratory Infection ◽  
Childhood Asthma ◽  
Syncytial Virus

Do Children Who Experience Laryngospasm Have an Increased Risk of Upper Respiratory Tract Infection?

1996 ◽  
Vol 85 (3) ◽  
pp. 475-480. ◽  
Author(s):  
Mark S. Schreiner ◽  
Irene O'Hara ◽  
Dorothea A. Markakis ◽  
George D. Politis
Keyword(s):  
Confidence Interval ◽  
Respiratory Infection ◽  
Odds Ratio ◽  
Signs And Symptoms ◽  
Control Group ◽  
Upper Respiratory Tract ◽  
Upper Respiratory Infection ◽  
Airway Surgery ◽  
Increased Risk ◽  
Upper Respiratory

Background Laryngospasm is the most frequently reported respiratory complication associated with upper respiratory infection and general anesthesia in retrospective studies, but prospective studies have failed to demonstrate any increase in risk. Methods A case-control study was performed to examine whether children with laryngospasm were more likely to have an upper respiratory infection on the day of surgery. The parents of all patients (N = 15,183) who were admitted through the day surgery unit were asked if their child had an active or recent (within 2 weeks of surgery) upper respiratory infection and were questioned about specific signs and symptoms to determine if the child met Tait and Knight's definition of an upper respiratory infection. Control subjects were randomly selected from patients whose surgery had occurred within 1 day of the laryngospasm event. Results Patients who developed laryngospasm (N = 123) were 2.05 times (95% confidence interval 1.21-3.45) more likely to have an active upper respiratory infection as defined by their parents than the 492 patients in the control group (P &lt; or = 0.01). The development of laryngospasm was not related to Tait and Knight's definition for an upper respiratory infection or to recent upper respiratory infection. Children with laryngospasm were more likely to be younger (odds ratio = 0.92, 95% confidence interval 0.87-0.99), to be scheduled for airway surgery (odds ratio = 2.08, 95% confidence interval 1.21-3.59), and to have their anesthesia supervised by a less experienced anesthesiologist (odds ratio = 1.69, 95% confidence interval 1.04-2.7) than children in the control group. Conclusion Laryngospasm was more likely to occur in children with an active upper respiratory infection, children who were younger, children who were undergoing airway surgery, and children whose anesthesia were supervised by less experienced anesthesiologists. Understanding the risk factors and the magnitude of the likely risk should help clinicians make the decision as to whether to anesthetize children with upper respiratory infection.

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