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

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

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.

References

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Fig. 1.
Age distribution of wheezing children infected with respiratory syncytial virus (RSV), human rhinovirus (HRV), human bocavirus (HBoV).
pard-21-334f1.tif
Fig. 2.
Seasonal distribution of wheezing children infected with respiratory syncytial virus (RSV), human rhinovirus (HRV), human bocavirus (HBoV).
pard-21-334f2.tif
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
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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