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The clinical profile of hospitalized pediatric patients with respiratory syncytial virus (RSV) is updated. An omnipresent cause of infection in the respiratory tract, in infants the classical clinical presentation of RSV is bronchiolitis. Considerable acute morbidity in infants has been associated with RSV infection, especially among those 1 to 3 months of age or those with chronic lung disease. Among 246 children whose medical records were reviewed, the most common diagnoses at the time of admission were bronchiolitis, pneumonia and possible septicemia. The three patients who died (1.2%) had congenital heart disease. Young age, chronic cardiopulmonary disease, male sex and a possible family history of asthma were among the common risk factors. Nationwide, RSV infection causes about 91,000 children to be hospitalized annually at a cost of about $300 million.

Respiratory syncytial virus (RSV) is the most frequent cause of serious respiratory infections such as pneumonia, bronchopneumonia and bronchiolitis in North American infants and children. RSV is a frequent cause of hospital-acquired infections in children and is often spread in day-care centers and community settings. RSV is primarily spread through direct contact. Hand-washing and wearing gloves, masks and goggles are important steps toward preventing its transmission. The antiviral substance ribavirin is used to treat RSV infections and appears to reduce the need for mechanical ventilation, supplemental oxygen and intensive care. The possibility of using gamma globulin injections to prevent RSV infections is being studied, and researchers are attempting to develop a vaccine for RSV.

Flexible fiberoptic bronchoscopy and a skin test may help in diagnosing tuberculosis in young children with lower respiratory tract illness. Tuberculosis may be difficult to diagnose in young children since they may not show any signs of infection. A nine-month-old Hispanic boy was admitted to the hospital in severe respiratory distress. A chest X-ray revealed lung injury. A purified protein derivative (PPD) skin test for tuberculosis was positive after 48 hours. The diagnosis was confirmed when Mycobacterium tuberculosis was identified in a fluid sample obtained by flexible fiberoptic bronchoscopy. Apparently, the child had been regularly exposed to two relatives undergoing treatment for either active tuberculosis or a positive PPD test. Upon discharge, the infant was placed on a triple regimen of antituberculous drugs for nine months. The child was doing well at the six-month follow-up.