Search

Objective. Neonates with fever generally undergo a full, invasive septic evaluation to exclude serious bacterial infection (SBI). The risk of SBI in febrile older infants and children with documented respiratory syncytial virus (RSV) infection has been found to be negligible. The purpose of this study was to investigate the prevalence of SBI in febrile infants who were younger than 8 weeks and had documented RSV infection and to compare the risk of SBI with control subjects who were febrile and RSV-negative. Methods. This was a retrospective cohort study of infants who were age 8 weeks or less and presented with documented fever to the emergency department at an urban children's hospital in October through April during a 4-year period. RSV-positive cases were gender- and age-matched to febrile RSV-negative control subjects. Clinical characteristics and the rate of SBI were compared between the 2 groups. Results. A total of 174 previously healthy infants with fever and a positive RSV antigen test were identified and matched with 174 previously healthy infants with fever and a negative RSV test. Infants with RSV infection were more likely to present with upper respiratory infection symptoms, increased work of breathing, and apnea. Overall, 2 patients in the RSV group had SBI (both with urinary tract infections), compared with 22 in the control group (relative risk: 0.009), 17 of which were urinary tract infections. Conclusions. The risk of SBI in febrile infants with RSV infection seems to be very low, particularly in comparison with a control group of RSV-negative infants. These data suggest that full septic evaluations are not necessary in nontoxic-appearing infants with a positive RSV test. It seems to be prudent to examine the urine in these infants, as there is a clinically relevant rate of urinary tract infection. fever, infants, respiratory syncytial virus, septic evaluations., ABBREVIATIONS. SBI, serious bacterial infection; RSV, respiratory syncytial virus; ED, emergency department; UTI, urinary tract infection; CSF, cerebrospinal fluid; WBC, white blood cell. Fever is a common presenting complaint in [...]

A vaccine against respiratory syncytial virus might prevent otitis media in young children. Otitis media is an inflammation or infection in the middle ear. Although it is often caused by bacteria, research has shown that some viruses may also cause otitis media. A 1999 study of 456 children with an upper respiratory tract infection found that 48 had respiratory syncytial virus in their middle ear. Seventy-four percent of the children with a respiratory tract infection caused by respiratory syncytial virus also had the virus in their middle ear. Influenza vaccines have lowered the incidence of otititis media.

Babies with bronchiolitis may aspirate food when fed orally. Bronchiolitis is an inflammation of the lungs. In children, it is often caused by respiratory syncytial virus (RSV). Researchers gave 12 babies with RSV bronchiolitis a barium swallow, which is used to evaluate swallowing. Three babies aspirated while they were sick but not 2 to 4 weeks later when they had recovered., Objective. Respiratory illnesses may cause feeding difficulties in infants. We studied the safety of oral feeding during respiratory syncytial viral (RSV) bronchiolitis in previously healthy infants. Methods. Twelve previously healthy infants (3-12 months) with RSV bronchiolitis underwent barium swallow studies during the acute phase of illness. Those with abnormal studies underwent repeat studies 2 to 4 weeks later. Results. The initial barium studies revealed aspiration in 3 infants. All repeat studies, performed 2 to 4 weeks later, were normal. Conclusions. Even previously healthy infants may be at risk of aspiration during RSV bronchiolitis. Pediatrics 1999;104:1389-1390; RSV, bronchiolitis, aspiration, feeding., ABBREVIATION. RSV, respiratory syncytial virus. Respiratory syncytial virus (RSV) is the major use of bronchiolitis in infants. In the acute phase, bronchiolitis is often associated with fever, nasal discharge, irritability, [...]