Clinical analysis and follow-up of neonatal lower respiratory tract infection with respiratory syncytial virus

Abstract

Objective To investigate the clinical features of neonatal lower respiratory tract infection (LRTI) with respiratory syncytial virus(RSV), and to explore the relationship between clinical features and recurrent cough or wheezing after discharge. Methods From May 2008 to May 2013, the data of 41 neonates diagnosed as LRTI with RSV infection in New Century International Children's Hospital were analyzed retrospectively.The clinical features and follow-up results were observed. Results All the neonates had cough, 92.7% (38/41 cases) had choking, 85.4% (35/41 cases) had runny nose and nasal obstruction, 31.7% (13/41 cases) had fever, 65.9%(27/41 cases) had whee-zing sound during physical examination, 29.3%(12/41 cases)of the neonates were accompanied with bacterial infection(n=29), in which 50.0% (6/12 cases) were infected by staphylococcus aureus.Compared to the neonates only with RSV infection, the proportion of fever was higher in those with RSV combined with bacterial infection(n=12) (χ2=6.034, P<0.05), and there were no statistical differences between the neonates with or without bacterial infection in white blood cell count and with or without shadow in chest X-ray(χ2 =0.859, 2.064, P=0.485, 0.202). Compared with the neonates without family history of atopy, the neonates with the family history of atopy were more likely to get wheezing (88.2%vs 57.1%, χ2=4.871, P<0.05)during primary infection.During the follow-up, there was higher proportion of children with family history of atopy in the group with subsequent recurrent cough and/or wheezing than in the group without subsequent recurrent cough and/or wheezing(71.4% vs 26.3%, χ2=6.388, P<0.05). Conclusions Cough, choking are most common symptoms in neonatal LRTI with RSV, and there is no wheezing sound during phy-sical examination in some neonates.LRTI with RSV is likely combined with bacterial infection.Wheezing is more common in the neonates with family history of atopy.The RSV LTRI neonates with family history of atopy incline to get subsequent recurrent cough or wheeze after discharge. Key words: Respiratory syncytial virus; Lower respiratory tract infection; Follow-up; Family history of atopy; Recurrent cough or wheeze; Infant, newborn