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Roentgenographic Features of Common Pediatric Viral Respiratory Tract Infections

Roentgenographic Features of Common Pediatric Viral Respiratory Tract Infections Abstract • Viral infections of the respiratory tract in infants and children are common. Little has been reported on roentgenographic findings associated with infection caused by common viruses other than with respiratory syncytial virus. We studied chest roentgenograms from 128 previously healthy infants and children who were infected with respiratory syncytial virus, parainfluenza virus, influenza virus, or adenovirus. Four common roentgenographic findings were detected: parahilar peribronchial infiltrates, hyperexpansion, segmental or lobar atelectasis, and hilar adenopathy. Diffuse interstitial infiltrates and significant pleural fluid accumulations rarely occurred in our series. We confirmed the popular but not well-documented belief that other common respiratory viruses can be associated with roentgenographic findings similar to those caused by respiratory syncytial virus. However, respiratory syncytial virus infection is associated with more abnormal chest roentgenograms than any of the other viruses regardless of the clinical syndrome. Hilar adenopathy was more common in adenovirus infection. Young infants had significantly more abnormal chest roentgenograms, with more hyperexpansion and parahilar peribronchial infiltration than older children. We also found a significant correlation between lobar atelectasis and severity of the illness. In infants and children with viral infection of the lower respiratory tract, roentgenographic information can be a useful adjunct to clinical viral diagnosis. (AJDC 1988;142:43-46) References 1. Glezen WP, Denny FW: Epidemiology of acute lower respiratory disease in children . N Engl J Med 1973;288:498-505.Crossref 2. Scanlon GT, Unger JD: The radiology of bacterial and viral pneumonias . Radiol Clin North Am 1973;11:317-338. 3. McCarthy PL, Spiesel SZ, Stashwick CA, et al: Radiographic findings and etiologic diagnosis in ambulatory childhood pneumonias . Clin Pediatr 1981;20:686-691.Crossref 4. Glezen WP: Viral and mycoplasmal pneumonia , in Rakel RE (ed): Conn's Current Therapy . Philadelphia, WB Saunders Co, 1985, pp 131-133. 5. Eriksson J, Nordshus T, Carlson KH, et al: Radiological findings in children with respiratory syncytial virus infection: Relationship to clinical and bacteriological findings . Pediatr Radiol 1986;16:120-122.Crossref 6. Swischuk LE, Hayden CK: Viral vs bacterial pulmonary infections in children (is roentgenographic differentiation possible?) . Pediatr Radiol 1986;16:278-284.Crossref 7. Tew J, Calenoff L, Berlin BS: Bacterial or nonbacterial pneumonia: Accuracy of radiographic diagnosis . Radiology 1977;124:607-612.Crossref 8. Hall CB, Douglas RG: Clinically useful method for the isolation of respiratory syncytial virus . J Infect Dis 1975;131:1-5.Crossref 9. Chonmaitree T, Howie VM, Truant AL: Presence of respiratory viruses in middle ear fluids and nasal wash specimens from children with acute otitis media . Pediatrics 1986;77:698-702. 10. Rice RP, Loda F: A roentgenographic analysis of respiratory syncytial virus pneumonia in infants . Radiology 1966;87:1021-1027.Crossref 11. Simpson W, Hacking PM, Court SDM, et al: The radiological findings in respiratory syncytial virus infection in children: II. The correlation of radiological categories with clinical and virological findings . Pediatr Radiol 1974;2:155-160.Crossref 12. Aherne W, Bird T, Court SDM, et al: Pathological changes in virus infections of the lower respiratory tract in children . J Clin Pathol 1970;23:7-18.Crossref 13. Osborne D: Radiographic appearance of viral disease of the lower respiratory tract in infants and children . AJR 1978;130:29-33.Crossref 14. Buthala DA, Soret MG: Parainfluenza type 3 virus infection in hamsters: Virologic, serologic and pathologic studies . J Infect Dis 1964;114:226-234.Crossref 15. Becroft DMO: Histopathology of fatal adenovirus infection of the respiratory tract in young children . J Clin Pathol 1967;20:561-569.Crossref 16. Hall CB, McBride JT, Walsh EE, et al: Aerosolized ribavirin treatment of infants with respiratory syncytial viral infection . N Engl J Med 1983;308:1443-1447.Crossref 17. Taber LH, Knight V, Gilbert BE, et al: Ribavirin aerosol treatment of bronchiolitis associated with respiratory syncytial virus infection in infants . Pediatrics 1983;72:613-618. 18. Hall CB, McBride JT, Gala CL, et al: Ribavirin treatment of respiratory syncytial viral infection in infants with underlying cardiopulmonary disease . JAMA 1985;254:3047-3051.Crossref 19. American Academy of Pediatrics, Committee on Infectious Diseases: Ribavirin therapy of respiratory syncytial virus . Pediatrics 1987; 79:475-477. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Roentgenographic Features of Common Pediatric Viral Respiratory Tract Infections

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1988.02150010053020
Publisher site
See Article on Publisher Site

Abstract

Abstract • Viral infections of the respiratory tract in infants and children are common. Little has been reported on roentgenographic findings associated with infection caused by common viruses other than with respiratory syncytial virus. We studied chest roentgenograms from 128 previously healthy infants and children who were infected with respiratory syncytial virus, parainfluenza virus, influenza virus, or adenovirus. Four common roentgenographic findings were detected: parahilar peribronchial infiltrates, hyperexpansion, segmental or lobar atelectasis, and hilar adenopathy. Diffuse interstitial infiltrates and significant pleural fluid accumulations rarely occurred in our series. We confirmed the popular but not well-documented belief that other common respiratory viruses can be associated with roentgenographic findings similar to those caused by respiratory syncytial virus. However, respiratory syncytial virus infection is associated with more abnormal chest roentgenograms than any of the other viruses regardless of the clinical syndrome. Hilar adenopathy was more common in adenovirus infection. Young infants had significantly more abnormal chest roentgenograms, with more hyperexpansion and parahilar peribronchial infiltration than older children. We also found a significant correlation between lobar atelectasis and severity of the illness. In infants and children with viral infection of the lower respiratory tract, roentgenographic information can be a useful adjunct to clinical viral diagnosis. (AJDC 1988;142:43-46) References 1. Glezen WP, Denny FW: Epidemiology of acute lower respiratory disease in children . N Engl J Med 1973;288:498-505.Crossref 2. Scanlon GT, Unger JD: The radiology of bacterial and viral pneumonias . Radiol Clin North Am 1973;11:317-338. 3. McCarthy PL, Spiesel SZ, Stashwick CA, et al: Radiographic findings and etiologic diagnosis in ambulatory childhood pneumonias . Clin Pediatr 1981;20:686-691.Crossref 4. Glezen WP: Viral and mycoplasmal pneumonia , in Rakel RE (ed): Conn's Current Therapy . Philadelphia, WB Saunders Co, 1985, pp 131-133. 5. Eriksson J, Nordshus T, Carlson KH, et al: Radiological findings in children with respiratory syncytial virus infection: Relationship to clinical and bacteriological findings . Pediatr Radiol 1986;16:120-122.Crossref 6. Swischuk LE, Hayden CK: Viral vs bacterial pulmonary infections in children (is roentgenographic differentiation possible?) . Pediatr Radiol 1986;16:278-284.Crossref 7. Tew J, Calenoff L, Berlin BS: Bacterial or nonbacterial pneumonia: Accuracy of radiographic diagnosis . Radiology 1977;124:607-612.Crossref 8. Hall CB, Douglas RG: Clinically useful method for the isolation of respiratory syncytial virus . J Infect Dis 1975;131:1-5.Crossref 9. Chonmaitree T, Howie VM, Truant AL: Presence of respiratory viruses in middle ear fluids and nasal wash specimens from children with acute otitis media . Pediatrics 1986;77:698-702. 10. Rice RP, Loda F: A roentgenographic analysis of respiratory syncytial virus pneumonia in infants . Radiology 1966;87:1021-1027.Crossref 11. Simpson W, Hacking PM, Court SDM, et al: The radiological findings in respiratory syncytial virus infection in children: II. The correlation of radiological categories with clinical and virological findings . Pediatr Radiol 1974;2:155-160.Crossref 12. Aherne W, Bird T, Court SDM, et al: Pathological changes in virus infections of the lower respiratory tract in children . J Clin Pathol 1970;23:7-18.Crossref 13. Osborne D: Radiographic appearance of viral disease of the lower respiratory tract in infants and children . AJR 1978;130:29-33.Crossref 14. Buthala DA, Soret MG: Parainfluenza type 3 virus infection in hamsters: Virologic, serologic and pathologic studies . J Infect Dis 1964;114:226-234.Crossref 15. Becroft DMO: Histopathology of fatal adenovirus infection of the respiratory tract in young children . J Clin Pathol 1967;20:561-569.Crossref 16. Hall CB, McBride JT, Walsh EE, et al: Aerosolized ribavirin treatment of infants with respiratory syncytial viral infection . N Engl J Med 1983;308:1443-1447.Crossref 17. Taber LH, Knight V, Gilbert BE, et al: Ribavirin aerosol treatment of bronchiolitis associated with respiratory syncytial virus infection in infants . Pediatrics 1983;72:613-618. 18. Hall CB, McBride JT, Gala CL, et al: Ribavirin treatment of respiratory syncytial viral infection in infants with underlying cardiopulmonary disease . JAMA 1985;254:3047-3051.Crossref 19. American Academy of Pediatrics, Committee on Infectious Diseases: Ribavirin therapy of respiratory syncytial virus . Pediatrics 1987; 79:475-477.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jan 1, 1988

References