M Zampoli1, Z Mukuddem-Sablay. 1. Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa. m.zampoli@uct.ac.za.
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.
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&lt;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.
Authors: Limin Li; Yen Yen Woo; Jessie Anne de Bruyne; Anna Marie Nathan; Sze Ying Kee; Yoke Fun Chan; Chun Wei Chiam; Kah Peng Eg; Surendran Thavagnanam; I-Ching Sam Journal: PLoS One Date: 2018-10-15 Impact factor: 3.240