Resumen

DALMAS, SUSANA et al. Infección respiratoria aguda baja por adenovirus en niños hospitalizados menores de dos años. Arch. Pediatr. Urug. [online]. 2003, vol.74, n.1, pp.15-21. ISSN 1688-1249.

Summary Introduction: acute lower respiratory infections (ALRI) represent an important cause of death in children under 5 years of age. In children under 2 years of age the aetiology is viral in 70-90% of the cases. Although adenoviruses only cause 2 - 5% of these they are of a significant importance because they have a high mortality rate, primarily linked to nosocomial outbreaks. Objective: we present the clinical and radiological characteristics of the disease and the outcome of children under two years of age affected by ALRI caused by adenovirus infections at the Centro Hospitalario Pereira Rossell during 2 different periods: May-November 1998 and May-September 1999. Methods: virological diagnosis was performed on nasopharyngeal aspirates by viral antigen detection with immunofluorescence (IF). Viral culture and isolation was also performed during the May-September 1999 period. Results: adenovirus infection was proven in 28 children, 25 cases with IF and in 10 cases with cell culture. In 6 of the 18 1998 cases and 1 of 1999 the infection was nosocomial. Most of the children were under 6 years of age at the time of infection, previously healthy and well nourished. The most frequent symptoms were cough, polypnea, chest retraction and prolonged fever. The most frequent radiological findings were interstitial infiltrates and hyperinsuflation, 9 cases showed images of dense consolidation. 10 out of 27 children were admitted to intensive care for respiratory support, 5 of which correspond to the nosocomial infection group. Four children died and five remained oxygen-dependent. Conclusion: the early suspicion of adenoviral infection and a management strategy that includes viral isolation and diagnosis could help diminish nosocomial infections and its related morbidity and mortality. The allocation of adequate financing should result in a great individual, institutional and social benefit.

Palabras clave : ADENOVIRUS INFECTIONS; HUMAN     RESPIRATORY TRACT INFECTIONS; CROSS INFECTION.

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