Analysis of the clinical characteristics of lower respiratory tract infection of influenza virus-related critical illness in children
10.3760/cma.j.issn.1673-4912.2020.07.006
- VernacularTitle:儿童下呼吸道流感病毒感染危重症临床特征分析
- Author:
Qin YANG
1
;
Hongling MA
;
Wei WANG
;
Yuejie ZHENG
Author Information
1. 深圳市儿童医院呼吸科 518026
- From:
Chinese Pediatric Emergency Medicine
2020;27(7):502-506
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics of lower respiratory tract infection of influenza virus-related critical illness in children, and provide reference for early diagnosis and treatment of the disease.Methods:Thirty influenza virus-related critical cases of lower respiratory tract infection admitted to Shenzhen Children′s Hospital from October 2018 to October 2019 were enrolled in our study, and the clinical data were compared with influenza virus-related common severe cases with lower respiratory tract infection.Results:We reported that 63.33% of children with critical illness were less than five years old, and most of them were male(25 cases, 83.33%). The incidence of critical cases in the summer was significantly higher compared with common severe cases( χ2=7.050, P=0.008). In addition, pulmonary rales were the most common lung signs in critical cases( χ2=5.222, P=0.022), and the incidence of severe pneumonia increased significantly( χ2=32.651, P<0.001). Besides, we noticed that 60.00% of critical cases had respiratory failure, and the prevalence rates of plastic bronchitis among critical cases significantly increased( χ2=7.797, P=0.005). The absolute counts of neutrophil and the proportion of C-reactive protein in critical cases were higher than those in common severe cases ( Z=-3.805, P<0.001; χ2=5.833, P=0.016). We also found that 30.00% of critically-ill cases had Streptococcus Pneumoniae in lavage, of whom Epstein-Barr(EB) virus detection rate was higher than that of common severe cases ( χ2=6.909, P=0.009). Conclusion:Critically ill cases of lower respiratory tract with influenza virus infection are more common in children under five years old.These cases mainly occur in summer.When patients with lung rales, the absolute counts of neutrophil and the C-reactive protein increased significantly, and specifically with streptococcus pneumoniae and EB virus infection, which are more likely to progress to severe cases.Severe pneumonia, plastic bronchitis and respiratory failure need to be close monitored as the serious complications of critical illness.Early anti-influenza viral and anti-bacterial treatment, as well as active symptomatic life support can improve the prognosis of the disease.
