Featuresof the human bocavirus infection
- Authors: Vavakina NA1, Kokoreva SP1, Pakhomova YA1, Razuvayev OA1
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Affiliations:
- N.N. Burdenko Voronezh State Medical University
- Issue: Vol 8, No 2 (2019)
- Pages: 669-670
- Section: Articles
- URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/5807
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Abstract
Background: Currently, there are more than 200 viral agents capable of causing damage to the respiratory tract in humans. At the present stage of development of laboratory diagnostics, it has become possible to conduct screening studies allowing to detect 9 viruses, including “new” viruses - human metapneumovirus (HMPV), human bocavirus (HBoV), human coronovirus (HCoV-HKH1, NL63), SARS. Today, the clinical picture of these infections in children is not studied enough. Aim: To identify the clinical features of the course of human bocavirus infection in hospitalized children. Methods: The study included 1024 children with laboratory-confirmed etiology of acute respiratory infection hospitalized in the regional infectious diseases hospital of the city of Voronezh from 2017 to 2018. The etiology of acute respiratory infections was confirmed by PCR smear from the pharynx and nose. All children underwent general clinical examination, chest radiography, and an ENT doctor consultation according to indications. Results: During this period, the human bocavirus infection was 3.8%. Clinical features were studied in the observation of 38 hospitalized children with laboratory-confirmed human bocavirus infection. Almost half of the children (42.1%) had thehuman bocavirus infection in association with other viral agents. Fever was observed in 97.4% of children, with a maximum number by 2 day . All children had catarrhal syndrome, with the development of rhinitis, a wet cough. Every third child with the human bocavirus infection had an increase in cervical lymph nodes. 15.7% of children were diagnosed with obstructive bronchitis. The development of respiratory failure occurred in 13.1% of children. One child developed laryngitis with stenosis of the larynx of the first degree. Conclusion: revealed autumn-winter seasonality of this infection. The disease is characterized by the development of intoxication syndrome, growing by the second day of the disease, catarrhal syndrome in the form of cough, rhinorrhea, nasal congestion, development of lymphoproliferative syndrome in every third child. The lower respiratory tract is characterized by the development of respiratory failure due to pneumonia in young children and obstructive bronchitis in children over three years old.
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BACKGROUND Currently, there are more than 200 viral agents capable of causing damage to the respiratory tract in humans. At the present stage of development of laboratory diagnostics, it has become possible to conduct screening studies allowing to detect 9 viruses, including “new” viruses - human metapneumovirus (HMPV), human bocavirus (HBoV), human coronovirus (HCoV-HKH1, NL63), SARS. Today, the clinical picture of these infections in children is not studied enough. AIM To identify the clinical features of the course of human bocavirus infection in hospitalized children. METHODS The study included 1024 children with laboratory-confirmed etiology of acute respiratory infection hospitalized in the regional infectious diseases hospital of the city of Voronezh from 2017 to 2018. The etiology of acute respiratory infections was confirmed by PCR smear from the pharynx and nose. All children underwent general clinical examination, chest radiography, and an ENT doctor consultation according to indications. RESULTS In the period from October 2017 to October 2018, the etiology of ARI was laboratory confirmed in 1024 children hospitalized in the regional infectious diseases hospital in the city of Voronezh. During this period, thehuman bocavirus infection was 3.8%, and in 2016/17 epidemic seasons, the proportion of the human bocavirus infection was 1.0% and 4.5%, respectively. The most frequent children with HBoV were hospitalized in the autumn months - in October, they accounted for 15.3% of all children with laboratory-confirmed etiology of ARI, in November - 13.6%, and in the winter period, human bocavirus infection was 15%. Clinical features were studied in the observation of 38 hospitalized children with laboratory-confirmed human bocavirus infection. Almost half of the children (42.1%) had the human bocavirus infection in association with other viral agents: 18.4% with parainfluenza, 10.5% with adenovirus and RS-infection, and 2.7% with rhinovirus infection. The number of boys and girls was about the same 57.8% and 42.2% accordingly. The age of children was from 6 months to 12 years: children under year - 21.0%, from year up 3 - 42.1%, from 3 to 6 years - 31.5%, older than 6 years - 5.4%. . Children were hospitalized at the clinic on 3 [2; 6] day of the disease, all children were referred by an emergency doctor. The disease developed gradually with fever and catarrhal syndrome. 97,4% of children had a fever, while 26,3% of children had low-grade fever throughout the disease, 58% had a high fever, 13,1% had a hyperthermia. Period during which temperature was lasted 3 [1; 4] days. At the same time, the peculiarity of fever in children was an increase in fever by the 2nd day of the disease. On the first day of disease, in 42.1% of children, the temperature rose up to febrile numbers, only 1 child was diagnosed with hyperthermic temperature, and 15.7% of children had normal temperature on the first day of the disease. On the second day of the disease, febrillitis was already noted in 55.2%, hyperthermia was present in 10.5% of children. All children had rhinitis: 65.7% of children had a copious discharge from the nose of a slimy character, 76.3% had a marked nasal congestion. The duration of the symptoms was 6 [5; 7] days. Every third child with human bocavirus infection showed an increase in the submandibular, anterior and posterior cervical lymph nodes, they were painless, mobile, not welded to the surrounding tissues, the skin above them was not changed. With the development of human bocavirus infection, all patients from the first day of the disease were bothered by a cough - in 42.1% the debut was from the dry cough, which remained for 2 [2; 4] days, and in 57.9%, from the first day of disease, the cough was productive and wet. The total duration of cough was 6 [4; 9] days. In every third child with human bocavirus infection, cough was due to the development of pneumonia, while only 54.5% of children had local small bubbling rale, which remained for 6 [5; 8] days. The development of pneumonia was significantly more frequently observed in younger children - 37.5% in the group of children over 3 years old, the proportion of pneumonia was 21.4% (p <0.05). It should be noted that almost all children (84.7%) with pneumonia gave the development of respiratory failure. In 15.7% of children with human bocavirus infection, obstructive bronchitis was diagnosed, the diagnosis was made based on the presence of auscultatory changes, dry whistling and moist various wheezing were heard for all pulmonary fields in all children, the duration of auscultation was 5 [5; 7] days. The development of respiratory failure in children with bronchitis occurred in 13.1% of children, mostly (83.3%) were children older than three years. One child under observation developed laryngitis with stenosis of the larynx of the first degree, in this patient an association of human bocavirus infection with parainfluenza was detected, which probably caused the development of stenosis. In order to identify other features of the clinical picture of mixed infections, a comparative analysis of the clinical picture of human bocavirus infection as a monoinfection and infection with human bocavirus infection as part of associations was carried out. It was revealed that respiratory failure was more common with mixed infections, 61.5%, versus 40.9% with monoinfection (p <0.05). At the same time, there were no significant differences in the incidence of complications in these groups, also there was the difference in height and duration of fever and other clinical manifestations. In complete blood count in every third child showed an increase in the number of leukocytes relative to the age norm of 1.58 [1.32; 1.81] times. 23.6% of children had a stab leukocyte shift of more than 5%, up to a maximum of 17%, an increase in erythrocyte sedimentation rate above 20 mm / hour was detected in 52.6%, with a maximum number of 48 mm / hour. These changes in laboratory parameters were recorded mainly in children with a complicated course of human bocavirus infection. The duration of hospitalization of children was 8 [6; 10] days, all children were discharged with recovery, in a satisfactory condition. DISCUSSION The analysis of the course of lateral infection in hospitalized children.Identified seasonality of the disease.The analysis of the clinical manifestations of the disease. Summary of the main result of the study The autumn-winter seasonality of the infection was revealed. The disease is characterized by the development of intoxication syndrome, growing by the second day of the disease, catarrhal syndrome in the form of cough, rhinorrhea, nasal congestion, development of lymphoproliferative syndrome in every third child. The lower respiratory tract is characterized by the development of respiratory failure due to pneumonia in young children and obstructive bronchitis in children over three years old. Discussion of the main result of the study The results obtained are consistent with known data published on the research topic. CONCLUSION In this way, the human bocavirus infection has an autumn-winter seasonality, characterized by a subacute start of the disease with a maximum temperature increase by day 2 of the disease, moderate catarrhal syndrome, with an increase in the cervical lymph nodes in every third child. Complications of the lower respiratory tract, with the development of respiratory failure due to pneumonia in young children and bronchitis with severe broncho-obstructive syndrome in children older than 3 years, are typical for the human bocavirus infection.×
About the authors
N A Vavakina
N.N. Burdenko Voronezh State Medical UniversityVoronezh,Russia
S P Kokoreva
N.N. Burdenko Voronezh State Medical UniversityVoronezh,Russia
Y A Pakhomova
N.N. Burdenko Voronezh State Medical UniversityVoronezh,Russia
O A Razuvayev
N.N. Burdenko Voronezh State Medical UniversityVoronezh,Russia
References
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