Respiratory Viruses; Today's Troubled Agents, Candidates for Marker of Diagnosis and Prognosis

Objective: The aim was to describe the clinical and epidemiologic characteristics of patients with lower res- piratory tract infection (LRTI) who were hospitalized to the Pediatric Infection Department in Istanbul due to respiratory viruses from October 2010 through May 2011. Material and Methods: Details of the 156 patients who were hospitalized were recorded. Respiratory viruses were con- firmed in specimens using real-time reverse transcriptase-polymerase-chain-reaction (RT PCR) assay. Results: Respiratory agents were detected in 48 (30.8%) of 156 children with LRTI. Fifty seven patients (36.5%) were female, 99 (63.5%) were male and the median age was 28.2 ±42.1 months. A single agent was identified in 41 (% 85) children, and multiple agents in 7 (%15). Influenza virus was the most common pathogen (31.2%), followed by rinovirus (20.8%), bocavi- rus (14.5%),coronavirus (10.4%), parainfluenza virus (8.3%), metapneumovirus (8.3%) and respiratory syncytial virus (6.2%). There were no statistically significant differences between the two groups (with isolated virus or no known viral etiology) with respect to symptoms, clinical findings, laboratory work-up, or radiological data except LDH level. Elevated levels of LDH in patients with respiratory virus were statistically significant. In addition, we showed a relationship between patients with the viral infection and peribronchial markings on chest X-ray (p = 0.017, OR 4071 CI :1.290-12, 843) and steroid therapy (p <0.001, OR 7870 CI :2.496-25, 000). Three patients (6.25%) received intensive care support and one patient with con- genital metabolic disease who was detected HMPV died. Conclusions: Diagnosis of respiratory viruses is essential not only for epidemiological data and for antiviral therapy because of easily able to achieve and increased diversity today. With all of influenza is major respiratory virus of LTRI and so vaccine program should evolve influenza vaccine for all children upper 6 months old.