Characteristics of Hospitalized Rhinovirus-Associated Community-Acquired Pneumonia in Children, Finland, 2003–2014

Hartiala, Maria; Lahti, Elina; Forsström, Ville; Vuorinen, Tytti; Ruuskanen, Olli; Peltola, Ville

doi:10.3389/fmed.2019.00235

Cited by 13 publications

(10 citation statements)

References 63 publications

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“…Clinical characteristics of rhinovirus-associated pneumonia were also observed in a retrospective study by Hartiala et al [7]. Of the 313 children with pneumonia, rhinovirus was detected in 82. e characteristics of children with rhinovirus-associated pneumonia were younger age (less than two years old), history of preterm birth, and higher median white blood cell count at presentation.…”

Section: Rhinovirus Pneumonia In the Pediatric Patientsupporting

confidence: 52%

Severe Pulmonary Infection in a 20-Month-Old Female

Mann

Zeller

Carrillo-Kappus

et al. 2020

Case Reports in Infectious Diseases

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Community-Acquired Pneumonia (CAP) is a common reason for hospitalization of a pediatric patient. We report a 20-monthold female admitted for suspected CAP. History included a week-long cough, fever, dyspnea, single occurrence of seizure-like activity, and a sick contact. Initial chest X-ray (CXR) showed left lower lobe pneumonia and parapneumonic effusion with a complex left pleural effusion. Ultrasound findings prompted the need for contrast-enhanced computed tomography (CT) of the chest. Contrast-enhanced CT of the chest confirmed a large pleural effusion with major atelectasis and mediastinal shift. e patient was treated with empiric antibiotics, video-assisted thoracoscopic surgical (VATS) decortication of empyema, and chest tube placement. Due to intraoperative complications, the VATS decortication was aborted and patient was transferred to the pediatric intensive care unit (PICU). A thoracentesis with culture failed to isolate a bacterial organism. Dexamethasone was started after repeat CXR showed persistent infiltrate. Subsequent contrast-enhanced CT of the chest showed a large collection of air and persistent consolidation. e patient received repeat VATS decortication and reinsertion of a chest tube. Repeat pleural fluid cultures failed to isolate a bacterial organism. Infectious disease (ID) consult recommended linezolid 140 mg Q8H for 4 weeks. Seven days after second VATS, a respiratory pathogen panel was positive for rhinovirus/enterovirus. With resolution of leukocytosis and clinical improvement, the patient was discharged with the chest tube in place and pediatric surgery outpatient follow-up. After three months, sequalae from both the infection and interventions presented .A 20-month-old Caucasian female presented to the Emergency Department (ED) with complaint of a week-long cough, fever, difficulty breathing, and a single instance of apparent seizure-like activity that resolved. She was seen at an urgent care 7 days prior to ED presentation and given prescriptions for albuterol and oseltamivir for suspicion of

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Section: Rhinovirus Pneumonia In the Pediatric Patientsupporting

confidence: 52%

Severe Pulmonary Infection in a 20-Month-Old Female

Mann

Zeller

Carrillo-Kappus

et al. 2020

Case Reports in Infectious Diseases

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“…However, it may also reflect a clinical decision for enhancement of testing in this high-risk population. Prematurity has also been identified as a risk factor for severe RV respiratory infections, including community-acquired pneumonia, and was present in 13% of children in our study [ 6 , 18 , 36 ]. Immunocompromised patients are at a greater risk of severe RV infections [ 8 , 37 ].…”

Section: Discussionmentioning

confidence: 85%

“…RVs are commonly associated with the common cold, being responsible for over one-half of all upper respiratory tract infections (URTI) across all age ranges [ 1 ]. More recently, RVs have also been implicated in lower respiratory tract infections such as bronchitis, community-acquired pneumonia [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ] bronchiolitis [ 1 , 4 , 8 ], and asthma exacerbations [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Viral Loads and Disease Severity in Children with Rhinovirus-Associated Illnesses

Sánchez-Códez

Moyer

Benavente‐Fernández

et al. 2021

Viruses

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The role of rhinoviruses (RVs) in children with clinical syndromes not classically associated with RV infections is not well understood. We analyzed a cohort of children ≤21 years old who were PCR+ for RV at a large Pediatric Hospital from 2011 to 2013. Using univariate and multivariable logistic regression, we analyzed the associations between demographic, clinical characteristics, microbiology data, and clinical outcomes in children with compatible symptoms and incidental RV detection. Of the 2473 children (inpatients and outpatients) with an RV+ PCR, 2382 (96%) had compatible symptoms, and 91 (4%) did not. The overall median age was 14 months and 78% had underlying comorbidities. No differences in RV viral loads were found according to the presence of compatible symptoms, while in children with classic RV symptoms, RV viral loads were higher in single RV infections versus RV viral co-infections. Bacterial co-infections were more common in RV incidental detection (7.6%) than in children with compatible symptoms (1.9%, p < 0.001). The presence of compatible symptoms independently increased the odds ratio (OR, 95% CI) of hospitalization 4.8 (3.1–7.4)), prolonged hospital stays 1.9 (1.1–3.1), need for oxygen 12 (5.8–25.0) and pediatric intensive care unit (PICU) admission 4.13 (2.0–8.2). Thus, despite comparable RV loads, disease severity was significantly worse in children with compatible symptoms.

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“…Other studies reported other types of bacteria, such as Staphylococcus aureus, Chlamydia pneumoniae, Mycoplasma, etc., which might also be present in pediatric patients with severe Rhinovirus pneumonia. 13,26 This difference might be likely due to the limited sample size in this study. The determination of bacterial coinfection in patients with severe Rhinovirus pneumonia is important in predicting the outcome and assisting in the development of the appropriate treatment plan.…”

Section: Discussionmentioning

confidence: 82%

“…20,21,[32][33][34] The optimal cutoff point for hs-CRP was 1.53 mg/dl (sensitivity 90%, specificity 56%), and the AUC for hs-CRP was 0.772, indicating this diagnostic value was valid. Although some authors were arguing that CRP is not useful in distinguishing coin-fected bacterial infections in patients with Rhinovirus community pneumonia, 26,35 other studies were confirming the ability to distinguish between viral and bacterial agents that cause pneumonia with CRP limit point > 0.8mg/dl. [36][37][38] Although controversies exist surrounding the use of the hs-CRP index to identify severe pneumonia caused by coinfection with the virus, this biomarker can still be used to support decisions about antibiotic use.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Different Biomarkers to Identify Bacterial Coinfection in Vietnamese Children with Severe Rhinovirus Pneumonia

Pham¹,

Nguyen

Tam

2020

Journal of Child Science

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This study aims to assess the diagnostic value of high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), and interleukin (IL)-6 in the diagnosis of pneumonia caused by Rhinovirus alone or with bacterial coinfection in Vietnamese children under 5 years of age. A cross-sectional study was conducted on 26 children under 5 years of age with severe pneumonia due to Rhinovirus at the National Pediatric Hospital. IL-6, hs-CRP, and PCT tests were performed. The diagnostic values of PCT, IL-6, and hs-CRP in classifying those with viral alone and those with bacterial coinfection were determined. Of 26 children, 10 children were diagnosed to have bacterial coinfections (38.5%). The optimal cutoff point for PCT was > 2.30 ng/mL (sensitivity 50%, specificity 94%, positive predictive value 83%, and negative predictive value 75%). The optimal cutoff point for hs-CRP was > 1.53 mg/dl (sensitivity 90%, specificity 56%, positive predictive value 56%, and negative predictive value 90%). Finally, the optimal cut-off point for IL-6 was > 441.5 pg/mL (sensitivity 20%, specificity 100%, positive predictive value 100%, and negative predictive value 60%). The accuracy rate of PCT was the highest with 69.2%, followed by hs-CRP with 65.4%. Inflammatory biomarkers such as PCT and hs-CRP were able to distinguish children with severe pneumonia caused by Rhinovirus alone and those with bacterial coinfection.

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Characteristics of Hospitalized Rhinovirus-Associated Community-Acquired Pneumonia in Children, Finland, 2003–2014

Cited by 13 publications

References 63 publications

Severe Pulmonary Infection in a 20-Month-Old Female

Severe Pulmonary Infection in a 20-Month-Old Female

Viral Loads and Disease Severity in Children with Rhinovirus-Associated Illnesses

Diagnostic Value of Different Biomarkers to Identify Bacterial Coinfection in Vietnamese Children with Severe Rhinovirus Pneumonia

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