Evaluation of Children with Congenital Heart Disease Hospitalized with the Diagnosis of Lower Respiratory Tract Infection

Aim: Lower respiratory tract infections are an important reason for mortality and morbidity in children with congenital heart disease. This study aimed to evaluate 50 children who had congenital heart disease and were hospitalized with lower respiratory tract infection in the Ege University Faculty of Medicine Pediatrics Hospital. Materials and Methods: Fifty pediatric patients were taken into the study. Their clinical symptoms, acute phase reactants, chest X-rays, bacterial culture of transtracheal aspirate, respiratory virus panel (with multiplex polimerase chain reaction) from nasopharyngeal swab were examined. The groups were evaluated in terms of age, gender, enviromental smoke exposure, living with school-aged siblings, Respiratory Syncytial virus (RSV) prophylaxis, hospitalization time, causative pathogen, additional risk factors. Results: Of the 50 cases, 12 (24%) were cyanotic, 38 (76%) were acyanotic. There were 26 boys and 24 girls. The most common diagnosis in the acyanotic group was hemodynamically significant VSD (isolated or with other diagnoses) with 20 cases. The average age of the cyanotic group was 23.88±28.81, and the acyanotic group was 12.25±15.45 months old. Hospitalizations most frequently occured in winter. The most frequent viral agent was RSV, which was not seen in the cyanotic group. All of the RSV infected patients were under 12 months old. In 16.7% of cyanotic and 52.6% of acyanotic patients there were extra risk factors such as immune deficiency, Down syndrome, prematurity, Di George syndrome, cerebral palsy, postoperative early period. Three cases lost their lives due to severe respiratory failure. There was no statistically significant difference between the two groups when compared for demografic variables, risk factors, causative pathogens, hospitalization times. Conclusion: Lower respiratory tract infections and especifically RSV pneumonia are important causes of mortality and morbidity in patients diagnosed with congenital heart disease. To prevent risk factors, more studies must be done.