Pediatric adenovirus pneumonia: clinical practice and current treatment

Frontiers in Medicine

Medicine

Jianshun Li¹  Wenwen Jin¹  Yiyang Zhou¹  Fei Gao¹  Jie Zhang¹  Yiting Zhu¹  Hao Yuan¹  Xinhui Qiu¹  Wei Lin² 

[1] Department of Pediatrics, The Second School of Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China;null;

关键词: pediatric;    severe adenovirus pneumonia;    early recognition;    therapy;    prognosis;   

DOI  :  10.3389/fmed.2023.1207568

 received in 2023-04-17, accepted in 2023-06-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

Adenovirus pneumonia is common in pediatric upper respiratory tract infection, which is comparatively easy to develop into severe cases and has a high mortality rate with many influential sequelae. As for pathogenesis, adenoviruses can directly damage target cells and activate the immune response to varying degrees. Early clinical recognition depends on patients’ symptoms and laboratory tests, including those under 2 years old, dyspnea with systemic toxic symptoms, atelectasis or emphysema in CT image, decreased leukocytes, and significantly increased C-reaction protein (CRP) and procalcitonin (PCT), indicating the possibility of severe cases. Until now, there is no specific drug for adenovirus pneumonia, so in clinical practice, current treatment comprises antiviral drugs, respiratory support and bronchoscopy, immunomodulatory therapy, and blood purification. Additionally, post-infectious bronchiolitis obliterans (PIBO), hemophagocytic syndrome, and death should be carefully noted. Independent risk factors associated with the development of PIBO are invasive mechanical ventilation, intravenous steroid use, duration of fever, and male gender. Meanwhile, hypoxemia, hypercapnia, invasive mechanical ventilation, and low serum albumin levels are related to death. Among these, viral load and serological identification are not only “gold standard” for adenovirus pneumonia, but are also related to the severity and prognosis. Here, we discuss the progress of pathogenesis, early recognition, therapy, and risk factors for poor outcomes regarding severe pediatric adenovirus pneumonia.

【 授权许可】

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Copyright © 2023 Zhang, Zhu, Zhou, Gao, Qiu, Li, Yuan, Jin and Lin.