Department of Pediatric Infectious Diseases, Wroclaw Medical University, 44 Bujwida St., 50-345, Wroclaw, Poland,
Adv Exp Med Biol. 2013;788:97-102. doi: 10.1007/978-94-007-6627-3_15.
The aim of the study was to retrospectively determine the incidence and clinical course of varicella-related respiratory complications in children during the 6-year period 2005-2010. We attempted to identify the predisposing factors and outcome of such complications. Clinical records of 237 children treated in an academic hospital of the Medical University in Wroclaw, Poland were reviewed, taking into consideration the reason for referral to the hospital, duration of hospitalization, and diagnosis. There were 28 (11.8 %) children (mean age 2.8 ± 2.8 years) in the cohort hospitalized with varicella-related respiratory complications. The infants younger than 1 year predominated (9/28). None of the children were previously immunized against varicella. Admission occurred 5.0 ± 2.8 days after the first symptoms of varicella. The source of infection was an older sibling in 13/28 cases. The mean duration of hospitalization was 5.4 ± 2.0 days. The main symptoms were fever (20/28), cough (26/28), tachypnea (11/28), and dyspnea (7/28). Chest X-ray was performed in eight children, confirming pneumonia in six cases. Based on blood gases, chest X-ray, and clinical symptoms, pneumonia was diagnosed in 15/28 and acute bronchitis in 8/28 children. Intravenous antiviral therapy with acyclovir was administered in 16/28 and antibiotics in 14/28 children. In two cases, oxygen therapy was required and one child presented respiratory failure treated in the Intensive Care Unit. We conclude that respiratory tract involvement in the course of varicella infection in children is relatively common. Age less than 1 and an infected older sibling seem major risk factors for respiratory complications.
本研究旨在回顾性确定 2005-2010 年 6 年间儿童水痘相关呼吸道并发症的发生率和临床病程。我们试图确定这些并发症的诱发因素和结果。我们回顾了波兰弗罗茨瓦夫医科大学附属医院收治的 237 名儿童的临床记录，考虑了转诊医院的原因、住院时间和诊断。在该队列中，有 28 名（11.8%）儿童（平均年龄 2.8±2.8 岁）因水痘相关呼吸道并发症住院。婴儿（9/28）占多数。这些儿童均未接受过水痘疫苗接种。发病后平均 5.0±2.8 天住院。13/28 例感染源为年长的兄弟姐妹。平均住院时间为 5.4±2.0 天。主要症状为发热（20/28）、咳嗽（26/28）、呼吸急促（11/28）和呼吸困难（7/28）。8 例患儿进行了胸部 X 线检查，证实了 6 例肺炎。根据血气、胸部 X 线和临床症状，15/28 例患儿诊断为肺炎，8/28 例患儿诊断为急性支气管炎。16/28 例患儿接受了阿昔洛韦静脉抗病毒治疗，14/28 例患儿接受了抗生素治疗。有 2 例患儿需要吸氧，1 例患儿出现呼吸衰竭，在重症监护病房治疗。我们得出结论，儿童水痘感染过程中呼吸道受累相对常见。年龄小于 1 岁和感染的年长兄弟姐妹是呼吸道并发症的主要危险因素。
