Loughlin Gerald M, Moscona Anne
Department of Pediatrics, Weill Medical College of Cornell University, 515 East 71st Street, New York, NY, USA.
Pediatr Clin North Am. 2006 Oct;53(5):929-59, ix-x. doi: 10.1016/j.pcl.2006.08.004.
Respiratory syncytial virus (RSV), the recently identified human metapneumovirus (HMPV), and the human parainfluenza viruses (HPIVs), cause most cases of childhood croup, bronchiolitis, and pneumonia. Influenza virus also causes a significant burden of disease in young children, although its significance in children was not fully recognized until recently. This article discusses pathogens that have been studied for several decades, including RSV and HPIVs, and also explores the newly identified viral pathogens HMPV and human coronavirus NL63. The escalating rate of emergence of new infectious agents, fortunately meeting with equally rapid advancements in molecular methods of surveillance and pathogen discovery, means that new organisms will soon be added to the list. A section on therapies for bronchiolitis addresses the final common pathways that can result from infection with diverse pathogens, highlighting the mechanisms that may be amenable to therapeutic approaches. The article concludes with a discussion of the overarching impact of new diagnostic strategies.
呼吸道合胞病毒（RSV）、最近发现的人偏肺病毒（HMPV）以及人副流感病毒（HPIVs），是导致大多数儿童喉炎、细支气管炎和肺炎病例的病因。流感病毒在幼儿中也会造成严重的疾病负担，不过直到最近其在儿童中的重要性才得到充分认识。本文讨论了已研究数十年的病原体，包括RSV和HPIVs，还探讨了新发现的病毒病原体HMPV和人冠状病毒NL63。新传染病原体出现的速度不断加快，所幸分子监测和病原体发现方法也同样迅速发展，这意味着新的病原体很快将被列入其中。关于细支气管炎治疗方法的部分探讨了由多种病原体感染可能导致的最终共同途径，突出了可能适用于治疗方法的机制。文章最后讨论了新诊断策略的总体影响。
