Overview.
Respiratory syncytial virus pneumonia, referred to as syncytial virus pneumonia, is a common pediatric interstitial pneumonia that most often occurs in infants and young children. It develops in young infants shortly after birth because the mother’s antibodies do not prevent infection.
Causes
Respiratory syncytial virus (RSV), abbreviated as syncytial virus, belongs to the family of Paramyxoviridae, and is the most common etiologic agent causing pediatric viral pneumonia. There is only one serotype of syncytial virus, with two subtypes, A and B. The virus has been shown to be the most common cause of pneumonia in children.
Symptoms
The disease is most common in infants and young children, more than half of which are less than 1 year old, and the incubation period is mostly 4 to 5 days. Initially, cough and nasal congestion are seen. 2/3 of the cases have high fever, but it is non-persistent, most of them last for 1-4 days, a few for 5-8 days, and 1/3 of the children have moderate fever, which mostly lasts for 1-4 days. In moderate and severe cases, there are more obvious dyspnea, stridor, lip and mouth bruising and triple concave sign, and a few severe cases may also be complicated by heart failure. Chest percussion usually has no turbid sounds, a few have clear sounds, lung auscultation mostly has rales and coarse and medium wet rales, a few may also have fine wet rales, and severe cases may be complicated by respiratory failure or even heart failure.
Examination
1. The total number of white blood cells is generally normal or low, and lymphocytes are predominant. If complicated by bacterial infection, the total number of leukocytes can be increased, and the classification of neutrophils is dominant.2. Virology and serology examination The diagnosis of this disease is mainly based on the results of virology and serology examination. In recent years, the use of nasopharyngeal secretion cells and serum IgM antibody indirect method of immunofluorescence technology, enzyme immunoassay technology can be used for rapid diagnosis of syncytial virus infection.3. X-ray examination, most of them have a small spot patchy shadow, and a large patchy one is extremely rare. l/3 of children have different degrees of emphysema.
Diagnosis
Preliminary diagnosis is mainly based on clinical manifestations and X-ray examination. Currently, immunofluorescence or immunoenzymatic techniques can be used for early and rapid diagnosis to help confirm the diagnosis.
Treatment
1. General treatment should pay special attention to general symptomatic supportive treatment, pay attention to isolation, prevent secondary bacterial or other viral infections. Keep the airway open, ultrasonic nebulization, back patting and sputum suction are simple and easy respiratory treatment. Oxygen inhalation when necessary, and even CPAP or mechanical ventilation and other respiratory support in severe cases.2. Antiviral therapy There is no ideal antiviral drug, and if necessary, nebulized inhalation therapy with triazolyl nucleoside (ribavirin) can be considered.3. Immunoglobulin Intravenous immunoglobulin can be added to support treatment in severe cases.