Background: The diagnosis and clinical management of lower respiratory tract infection (LRTI)
pose challenges to pediatricians, as new technology is developed and new pathogens emerge in the
spectrum of clinical diagnosis. Objective: rapid diagnosis of viruses and atypical bacteria as
causative agents of LRTI in Benha hospitalized children using pneumoslide M test. Study design:
this cross-sectional study included 60 children with acute LRTI (pneumonia, bronchiolitis, and
croup); 34 (56.7%) males arid 26 (43.3%) females. Their mean age was 9.75 ± 5.6 months and
their mean weight was 7.25 ± 1.9 kg. All cases were subjected to complete history taking, thorough
clinical examination, and laboratory tests which included: complete blood count (CBC), C-reactive
protein (CRP), nasopharyngeal aspirate smear and culture. According to the microbiological
diagnosis, the studied cases were classified into two groups: -Group I ,35 cases (bacterial infection
group) and Group II, 25 cases(non bacterial infection group).Cases of group II only were
subjected to pneumoslide M test (an indirect immunofluorescence test for detection of serum IgM
against respiratory viruses and atypical bacteria).Resufts: the results of this study show high
significant statistical values in age of group II compared to group I ( pS 0.001) . In addition, the
sixty studied cases were diagnosed as bacterial infection in 35 cases (58.3%), viral and atypical
bacterial infections in 23 case.g (38.3%) and two cases were Undiagnosed (3.4%). In group 11 (25
cases) the diagnosis was as follows :- respiratory syncytial virus (RSV) infection in 9 cases (36%)
,para influenza virus (NV) infection in 6 cases (24%) ,adenovirus infection in 4 cases (16%) and
influenza A virus infection in 3 cases (12%), while one case only (4%) was diagnosed as M
pneumoniae and 2 cases(8%) were undiagnosed. Cases with RSV infection presented clinically as
bronchiolitis in 7 cases (77.8%) and pneumonia in 2 cases (22.2%).Also, cases with PIV infection
were diagnosed clinically as croup in 3 cases(50%), bronchiolitis in 2 cases (33.3%) and
pneumonia in one case(16.7%),while cases with adenovirus infection (4 cases) presented equally as
50% pneumonia and 50% bronchiolitis. Influenza A virus infected cases presented with pneumonia
in two cases(66.7%) and bronchiolitis in one case(33.3%) while the M.pneumoniae infected case
presented clinically with pneumonia. There are significant statistical values (p<0.05) regarding the
relation of PLY infection with pneumonia, bronchiolitis, and croup, while there are insignificant
statistical values (p>0.05) in the relation of other viral and M.pneumoniae infections with their
clinical diagnosis. As regards to the seasonal distribution of non-bacterial LRTI, it was found that
RSV and PIV infections were present all over the year while M.pneumoniae, adenovirus and
influenza A viral infections were detected in winter only. |
