Comparison of Clinical Manifestations of RSV, Rhinovirus and Bocavirus Infections in Children with Acute Wheezing

Hyun Wook Shin; Ha Lim Cho; Ju Hee You; Eun Jung You; Eun Young Kim; Kyoung Sim Kim; Yong Wook Kim; Jin Jong Seo; Hyoung Min Cho

doi:10.7581/pard.2011.21.4.334

Journal List > Pediatr Allergy Respir Dis > v.21(4) > 1033146

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Shin, Cho, You, You, Kim, Kim, Kim, Seo, and Cho: Comparison of Clinical Manifestations of RSV, Rhinovirus and Bocavirus Infections in Children with Acute Wheezing

Abstract

Pediatr Allergy Respir Dis 2011;21(4):334-343.

Published online: 20 January 2011

DOI: https://doi.org/10.7581/pard.2011.21.4.334

Comparison of Clinical Manifestations of RSV, Rhinovirus and Bocavirus Infections in Children with Acute Wheezing

Hyun Wook Shin, MD¹, Ha Lim Cho, MD¹, Ju Hee You, MD¹, Eun Jung You, MD¹, Eun Young Kim, MD¹, Kyoung Sim Kim, MD¹, Yong Wook Kim, MD¹, Jin Jong Seo, MS², Hyoung Min Cho, MD^1,

¹Department of Pediatrics, Kwangju Christian Hospital, Gwnagju, Korea

²Division of Microbiology, Department of Health Science, Gwangju Health and Environment Research Institute, Gwnagju, Korea

책임저자:조형민, 광주광역시 남구 양림동 264번지 광주기독병원 소아청소년과 Tel: 062)650-5045 Fax: 062)650-5040 E-mail: drcho92@hanmail.net

Received 29 August 2011 Revised 29 September 2011 Accepted 7 October 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to compare clinical manifestations of human bocavirus (hBoV), respiratory syncytial virus (RSV), and human rhinovirus (hRV) in children with acute wheezing.

Methods

We retrospectively investigated 549 virus-positive throat swabs obtained between January 2006 and December 2008 from pediatric inpatients with acute respiratory tract disease at Kwangju Christian Hospital. Among them, 109 patients, who had lower respiratory tract infections with wheezing, were enrolled in this study. The medical records of patients with positive results were reviewed for clinical data.

Results

The mean age of the patients with RSV was 7.15 months, 15.66 months in those with hRV, and 15.04 months in those with hBoV. The mean fever duration and frequency of patients with fever was 2.43 days and 47.9% for RSV, 2.86 days and 51.7% for hRV, and 3.75 days and 69.6% for hBoV. The frequency of patients with acute otitis media was 20.8% in the RSV, 20.7% in the hRV, and 13.0% in the hBoV groups. The frequency of lung infiltration on chest X-ray was 12.5% in the RSV, 20.7% in the hRV, and 47.8% in the hBoV groups.

Conclusion

We compared the clinical manifestations of respiratory viral infections in infants and children with wheezing. However, further surveillance will be necessary to clarify the clinical manifestations of the viruses.

Keywords: Bocavirus, RSV, Rhinovirus, Wheezing, Children, Korea

References

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Fig. 1.

Age distribution of wheezing children infected with respiratory syncytial virus (RSV), human rhinovirus (HRV), human bocavirus (HBoV).

Fig. 2.

Seasonal distribution of wheezing children infected with respiratory syncytial virus (RSV), human rhinovirus (HRV), human bocavirus (HBoV).

Table 1.

Symptom Scoring System (Reprinted from Boogaard R, Hulsmann AR, van Veen L, Vaessen-Verberne AA, Yap YN, Sprij AJ, et al. Chest 2007;131:788–95, with permission of American College of Chest Physicians) [20].

Variables	0 points	1 points	2 points	3 points
Respiratory rate, breaths/min	<30	31–45	46–60	>60
Wheezing	None	End-expiratory or only audible with stethoscope	Entire expiratory or audible on expiration without stethoscope	Inspiration and expiration; audible without stethoscope
Retractions	None	Intercostal	Tracheosternal	Severe with nasal flaring

Table 2.

Viral Etiology of Respiratory Infection in 109 Children with Acute Wheezing during a 3-year Study Period

Virus(es)	No. of children infected with virus (%)
RSV	48 (44.03)
HRV	29 (26.60)
HBoV	23 (21.10)
ADV	2 (1.83)
PIV	3 (2.75)
HCoV	1 (0.93)
IFV B	2 (1.83)
RSV and hBoV -coinfection	1 (0.93)
Total	109 (100%)

RSV, respiratory syncytial virus; HRV, human rhinovirus; HBoV, human bocavirus; ADV, adenovirus; PIV, parain-fluenzavirus; HCoV, human coronavirus; IFV B, infuenza virus B.

Table 3.

Characteristics of Children with Acute Wheezing Caused Solely by HBoV, Rhinovirus, and RSV

	No. of patient	Mean age (mo)	Fever		Mean
	No. of patient	Mean age (mo)	n (%)	day	Duration of admission (day)	WBC count, / L μ	ESR, (mm/hr)	CRP, (mg/dL)
RSV	48	7.15^∗	23 (47.9)	2.43	8.48	10,070	15.81	0.87
HRV	29	15.66	15 (51.7)	2.73	9.23	11,525	20.33	1.53
HBoV	23	15.04	16 (69.6)	3.75	9.09	13,800^†	25.78	0.72

WBC, white blood cell; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; RSV, respiratory syncytial virus; HRV, human rhinovirus; HBoV, human bocavirus.

^∗ RSV vs. HRV P<0.05; RSV vs. HBoV, P<0.005.

^† HBoV vs. RSV, P<0.05.,

Table 4.

Characteristics of Children with Acute Wheezing Caused Solely by HBoV, Rhinovirus, and RSV

	No. of patients with AOM (%)	Lung infiltration rate (%)	Severity score	Duration of wheezing (day) Mean	O2 inhalation rate (%)
RSV	10 (20.8)	12.5	4.88	6.17^‡	10.4
HRV	6 (20.7)	20.7	4.17	4.59	10.3
HBoV	3 (13.0)^∗	47.8^†	4.17	5.11	8.7

AOM, acute otitis media; RSV, respiratory syncytial virus; HRV, human rhinovirus; HBoV, human bocavirus.

^∗ HBoV vs. RSV,P<0.05; HBoV vs. HRV, P<0.05.

^† HBoV vs. RSV, P<0.005; HBoV vs. HRV, P<0.05.

^‡ RSV vs. HRV, P<0.05; RSV vs. HBoV, P<0.005.

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