RSV Pneumonia in the Pediatric Intensive Care Unit

Abstract

Objective: Respiratory syncytial virus (RSV) is the most common and fatal cause of bronchiolitis and severe pneumonia, especially in infants. Its morbidity and mortality are unpredictably high in critically ill patients. The aim of our study is to identify high-risk patients for early diagnosis and treatment of RSV pneumonia in the pediatric intensive care unit and to reduce hospitalizations and mortality. We want to emphasize the importance of vaccination and followup for the protection of other viral or bacterial pneumonia once again. Material and Methods: We present 12 cases that were diagnosed as RSV pneumonia in our tertiary pediatric intensive care unit. Besides history, physical examination, and chest radiograph findings, patients were diagnosed with laboratory tests, such as complete blood count, c-reactive protein (CRP), and virus isolation with nasal smear samples. Demographic, clinical, and laboratory data were obtained from patients' medical files. Results: Within 5 months of the study, 12 patients were diagnosed with RSV pneumonia. Risk factors were present in 11. Two of the patients were 35 weeks premature; others were born full-term, and none of them had received palivizumab prophylaxis. Except for a patient with a history of episodes of bronchiolitis, all of the patients had one or more risk factors for pneumonia. Nine of the patients (75%) were male, while 3 were female. Median age was 18.5 months (min: 2; max: 53 months). Five of our patients required mechanical ventilation. Two patients could not be separated from the ventilator; so, tracheostomy was performed and patients were discharged with home ventilation. One of the patients included in the study died. Conclusion: We want to emphasize that RSV, seen especially in infants, is also an important factor in older children; it might be fatal, and pediatric intensive care admission might be necessary. Therefore, before determining medical therapy, underlying risk factors should be remembered. © 2014 by Pediatric Infectious Diseases Society.