南非儿童腺病毒相关性肺炎：临床表现、临床病程及转归

Adenovirus-associated pneumonia in South African children: Presentation, clinical course and outcome.

作者信息

Zampoli M, Mukuddem-Sablay Z

机构信息

Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.

出版信息

S Afr Med J. 2017 Jan 30;107(2):123-126. doi: 10.7196/SAMJ.2017.v107i2.11451.

DOI:10.7196/SAMJ.2017.v107i2.11451

PMID:28220737

Abstract

BACKGROUND

Viruses have emerged as important aetiological agents of childhood pneumonia.

OBJECTIVE

To investigate the clinical presentation, severity and outcome of adenovirus-associated pneumonia (AVP) in children.

METHODS

A retrospective analysis of AVP cases over 12 months was performed, including demographic, clinical course and outcome (death, persistent lung disease (PLD)) data.

RESULTS

Two hundred and six AVP cases (median age 12 months, interquartile range 6 - 24) were identified; 70 children (34.0%) were malnourished and 14 (6.8%) were HIV-infected. Twenty-nine children (14.1%) developed PLD, which was associated with hypoxia at presentation in 26 cases (89.7%; p=0.01) and necessitated admission to the intensive care unit (ICU) in 18 (62.1%; p<0.01); 18/206 children (8.7%) died. Admission to the ICU (odds ratio (OR) 8.3, 95% confidence interval (CI) 2.3 - 29.0) and a positive blood culture (OR 11.2, 95% CI 2.3 - 54.1) were independent risk factors for mortality.

CONCLUSIONS

Adenovirus is a potential cause of pneumonia and PLD in young children in South Africa. ICU admission and a positive blood culture were associated with poor outcome.

摘要

背景

病毒已成为儿童肺炎的重要病因。

目的

调查儿童腺病毒相关性肺炎（AVP）的临床表现、严重程度及转归。

方法

对12个月内的AVP病例进行回顾性分析，包括人口统计学、临床病程及转归（死亡、持续性肺病（PLD））数据。

结果

共识别出206例AVP病例（中位年龄12个月，四分位间距6 - 24）；70名儿童（34.0%）营养不良，14名（6.8%）感染HIV。29名儿童（14.1%）发生PLD，其中26例（89.7%；p=0.01）在就诊时伴有低氧血症，18例（62.1%；p<0.01）需要入住重症监护病房（ICU）；206名儿童中有18名（8.7%）死亡。入住ICU（比值比（OR）8.3，95%置信区间（CI）2.3 - 29.0）及血培养阳性（OR 11.2，95%CI 2.3 - 54.1）是死亡的独立危险因素。