Rudolph Henriette, Gress Katharina, Weiss Christel, Schroten Horst, Adams Ortwin, Tenenbaum Tobias
Paediatric Infectious Diseases, University Children's Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany.
Institute of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany.
Pathogens. 2021 Aug 20;10(8):1061. doi: 10.3390/pathogens10081061.
Febrile seizures (FS) affect up to 5% of children. The pathogen etiology in regard of viral loads has never been investigated. In a prospective cohort study we investigated the correlation between virus type and quantity in nasopharyngeal aspirates (NPAs) and the clinical characteristics in pediatric patients with a FS. From January 2014 to April 2016, 184 children with a FS were prospectively enrolled. The mean age of all included children was 26.7 ± 18.3 months with a male to female ratio of 1.4:1. Males with an acute disease and a short duration or absence of prior symptoms had a higher risk for complex FS. The majority of patients with FS presented with a generalized convulsion (180; 98%) and was admitted to hospital (178; 97%). Overall, 79 (43%) single and in 59 (32%) co-infections were detected. Human herpes virus 6 (HHV6), influenza, adenovirus (AV) and rhinovirus (RV) were the dominant pathogens, all detected with clinically significant high viral loads. HHV6 positive cases were significantly younger and less likely to have a positive family/personal history for FS. Influenza positives showed a higher rate of complex seizures, lower leukocyte and higher monocyte counts. AV positive cases were more likely to have a positive family history for FS and showed higher C-reactive protein values. In conclusion, a high viral load may contribute to the development of a FS in respiratory tract infections.
热性惊厥(FS)影响着多达5%的儿童。关于病毒载量的病原体病因从未被研究过。在一项前瞻性队列研究中,我们调查了鼻咽抽吸物(NPA)中的病毒类型和数量与热性惊厥儿科患者临床特征之间的相关性。从2014年1月至2016年4月,前瞻性纳入了184例热性惊厥儿童。所有纳入儿童的平均年龄为26.7±18.3个月,男女比例为1.4:1。患有急性疾病、病程短或无前驱症状的男性发生复杂性FS的风险更高。大多数热性惊厥患者表现为全身性惊厥(180例;98%)并入院治疗(178例;97%)。总体而言,检测到79例(43%)单一感染和59例(32%)合并感染。人疱疹病毒6型(HHV6)、流感病毒、腺病毒(AV)和鼻病毒(RV)是主要病原体,均检测到具有临床意义的高病毒载量。HHV6阳性病例年龄显著更小,热性惊厥的家族/个人史阳性可能性更低。流感病毒阳性病例复杂性惊厥发生率更高,白细胞计数更低,单核细胞计数更高。腺病毒阳性病例热性惊厥家族史阳性可能性更大,C反应蛋白值更高。总之,高病毒载量可能促成呼吸道感染时热性惊厥的发生。