Clinical Features, Virus Identification, and Sinusitis as a Complication of Upper Respiratory Tract Illness in Children Ages 4-7 Years

详细信息    查看全文

• 作者：Gregory P. DeMuri ; MD¹ ; James E. Gern ; MD¹ ; Stacey C. Moyer ; RN ; MSN¹ ; Mary J. Lindstrom ; PhD² ; Susan V. Lynch ; PhD³ ; Ellen R. Wald ; MD¹
• 关键词：ADV ; Adenovirus ; CoV ; Coronavirus ; EV ; Enterovirus ; FLU ; Influenza virus ; GEE ; Generalized estimating equation ; hBoV ; Human bocavirus ; hMPV ; Human metapneumovirus ; PIV ; Parainfluenza virus ; RSV ; Respiratory syncytial virus ; RV ; Rhinovirus ; URI ; Upper respiratory tract illness
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：171
• 期：Complete
• 页码：133-139.e1
• 全文大小：841 K

文摘

To determine the rate of sinusitis complicating upper respiratory tract illnesses (URIs) in children. We prospectively identified the clinical, virologic, and epidemiologic characteristics of URIs in a population of 4- to 7-year-old children followed for 1 year.

Study design

This was an observational cohort study in 2 primary care pediatric practices in Madison, Wisconsin. Nasal samples were obtained during 4 asymptomatic surveillance visits and during symptomatic URIs. A polymerase chain reaction-based assay for 9 respiratory viruses was performed on nasal samples. A diagnosis of sinusitis was based on published criteria.

Results

Two hundred thirty-six children ages 48-96 months were enrolled. A total of 327 URIs were characterized. The mean number of URIs per child was 1.3 (range 0-9) per year. Viruses were detected in 81% of URIs; rhinovirus (RV) was most common. Seventy-two percent of URIs were resolved clinically by the 10th day. RV-A and RV-C were detected more frequently at URI visits; RV-B was detected at the same rate for both asymptomatic surveillance visits and URI visits. Sinusitis was diagnosed in 8.8% of symptomatic URIs. Viruses were detected frequently (33%) in samples from asymptomatic children.

Conclusions

Sinusitis occurred in 8.8% of symptomatic URIs in our study. The virus most frequently detected with URIs in children was RV; RV-A and RV-C detection but not RV-B detection were associated with illness. Viruses, especially RV, are detected frequently in asymptomatic children. Most URIs have improved or resolved by the 10th day after onset. Children experienced a mean of 1.3 URIs per year, which was lower than expected.