Etiology And Clinical Manifestation Studies On Infantile Viral Pneumonia

Objective：Explored the viral pathogeny、clinical manifestations,the relationbetween invasion age and virus distribution,Roentgenographic examination of356case of infantile pneumonia, to provide the basis of clinical diagnosis andtreatment. Method：1. Established the method of direct immunofluorescence(DFA)。2.Specimen source There were356infantile cases in ChangchunChildren Hospital from2012.1.1～2012.2.29, which was all in keeping withthe diagnoses criterion of the Sixth edition of Pediatrics Learning.On thecondition that the result of detecting by DFA was positive、 C-reactiveprotein(CRP) was less than8mg/L and there were no clinical、laboratory proofof other pathogeny infection,we totally selected158cases of infantile viralpneumonia who had already been diagnosed infantile pneumonia.3. By directimmunofluorescence assay(DFA) detected seven kinds of viruses, respiratorysyncytial virus (RSV), adenovirus (ADV), influenza viruses (IFVA, B),parainfluenza virus (PIV1-3), in nasal or throat secretions of children withpneumonia.4. Analyzed etiology、 clinical manifestations,the relationbetween invasion age and virus distrib-ution,Roentgenographic examinationof viral pneumonia on infants.Results:1.Virus pathogenesis In356infantilepneumonia cases, positive samples were158cases, accounting for44.38%.There were144single viral infectious cases in158cases of positivesamples,accounting for91.14%，68cases of Respiratory syncytial virus(RSV) infection, accounting for43.04%，34cases of Adenov-irus (ADV)infection，accounting for21.52%，25cases of Parainfluenza virus3(PIV3)infection， accounting for15.82%，15cases of Influenza virus B(IFVB) infection，accounting for9.49%，1cases of Parainfluenza virus1(PIV1)infection，accounting for0.63%，1cases of Parainfluenza virus2(PIV2)infection，accounting for0.63%，0cases of Influenza virus A(IFVA) infection，accounting for0.00%。 there were14mixed viral infectiouscases(8.86),successively they were RSV+IFVB:6cases（3.80%），RSV+PIV3:5cases(3.16%)，IFVB+PIV3:3cases(1.90%.The ratio of single viral infection andmixed viral infection was about10.3:1。2. Clinical characteristics①Clinicalsympotoms、physical signs Among144single viral infectious cases,fever:62cases (43.1%),polypnea:85cases (59.0%)，cyanosis：54cases(37.5％), cough:134cases (93.1%),asthma：78cases(54.2％)，dyspnea：55cases(38.2％)，medium and refined moist rale：101cases(70.1％)，wheezing rale:72cases(50.0％)，diarrhoea:23cases (16.0％).②To sum up fever (22.1%) in RSVpneumonia infant were significantly less than ADV pneumonia group and theIFV pneumonia group (p<0.05),polypnea(86.8%) in RSV pneumonia infantwere significantly more than ADV pneumonia group and the IFV pneumoniagroup (p<0.05), asthma (86.8%) in RSV pneumonia infant were significantlymore than ADV pneumonia group and the IFV pnermonia group(p<0.05),wheezing rale (85.3%) in RSV pneumonia infant were significantlymore than ADV pneumonia group、PIV pneumonia group and the IFVpneumonia group (p<0.05). ADV pneumonia infant fever(85.3%)、Cough（85.3%）commonly，dyspnea (52.9％)，poisoning symptom were serious，often diarrhoea（20.6%）,wheezing rale (17.6％)，medium and refined moistrale was easily heard(64.7%)，PIV pneumonia infant fever(18.5%)、cough(88.9%),and asthma was rare(14.8%),the dry rale(14.8%) and moist rale(59.3%)could be heard. IFV pneuonia infant fever (86.7%)、cough(86.7%) seriously，asthma(66.7%) commonly， often accompanied with diarrhoea(73.3%)， diarrhoea in IFV pneumonia infant were significantly more than ADVpneumonia group、RSV pneumonia group and the PIV pneumonia group(p<0.05).the refined moist rale(80.0%) were easily heard, wheezing rale(26.7%).3.Invasion age and Roentgenographic examination show①RSVpneumonia often break out in6month years old and less infant(76.5％),Roentgenographic examination in RSV pneumonia was often Lung textureincrease (98.5%), patchy infiltration(38.2%) in RSV pneumonia weresignificantly less than ADV pneumonia group and the IFV pneumonia group(p<0.05),and emphysema(76.5%) in RSV pneumonia were significantly morethan PIV pneumonia group and the IFV pneumonia group (p<0.05).②ADVpneumonia often break out in6～36month years old infant(88.3％),Roentgenographic examination in ADV pneumonia was often Lung textureincrease(88.2%)、 emphysema (73.5%)、 patchy infiltration(70.6%).③PIVpneumonia often break out in6～36month years old infant(77.7％),Roentgenographic examination in PIV pneumonia was often Lung textureincrease(88.9%), patchy Infiltration（48.1%）.④IFV pneumonia often break outin6～36month years old infant(73.3％), Roentgenographic examination inIFV pneumonia was often patchy infiltration(86.7%)、 Lung textureincrease(100.0%),and rare emphysema(0.0%). Conclusions:1. Virus infectionswere the one of main pathogenesis of infantile pneumonia in this group, Themajority was single viral infection.Among them RSV was the first，The mixedviral infection was rare。 There is the area’s discrepancy in the viraletiology.2.Various types of viral infantile pneumonia had their owncharacteristics.