ABSTRACT
Parainfluenza virus infections (PIV) were evaluated in patients with mild and severe infections through real time PCR. One thousand and sixty-seven samples were collected from subjects as follows: 233 adult renal transplanted outpatients, 129 children with congenital heart disease, 381 with adult hematopoietic stem cell patients and 324 hospitalized patients suspected of influenza A (H1N1) pdm09 infection. PIV was detected in 74 (6.9%) samples. VPI-3 was the most frequent (60.8%) and a higher risk was observed for older adults (p = 0.018) and for those who were hematopoietic stem cell transplanted. Further studies are needed to understand the VPI role in patients' at risk for developing serious illness.
Se evaluó la infección por virus parainfluenza (VPI) en pacientes con infecciones leves y graves mediante RPC en tiempo real. Se analizó un total de 1.067 muestras: 233 provenían de pacientes ambulatorios adultos receptores de trasplantes renales, 129 de niños con cardiopatía congénita, 381 de pacientes receptores de trasplantes de precursores hematopoyéticos adultos y 324 de pacientes hospitalizados con sospecha de influenza A (H1N1) pdm09. Se detectó VPI en 74 muestras (6,9%). Siendo VPI-3 el virus más frecuente (60,8%), se observó un mayor riesgo para los adultos mayores (p = 0,018) y para aquellos que fueron receptores de precursores hematopoyéticos. Son necesarios estudios adicionales para entender el papel del VPI en pacientes de riesgo para desarrollar enfermedad grave.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Immunocompromised Host/immunology , Paramyxoviridae Infections/immunology , Seasons , Severity of Illness Index , Brazil , Paramyxoviridae/isolation & purification , Retrospective Studies , Paramyxoviridae Infections/virology , Tertiary Care CentersABSTRACT
Disseminated encephalomyelitis (ADEM) is an infrequent condition with considerable morbidity and mortality in adult patients. It requires a high level of suspicion and diagnosis emerges by gathering clinical information, laboratory exams and images studies. ADEM is related to an immunological phenomena occurring after a bacterial/viral infection or recent vaccination. Glucocorticoids are the first line treatment, reserving immunoglobulins and plasmapheresis to refractory cases. We report a male patient aged 25, with ADEM associated to parainfluenza 3 virus respiratory infection that required mechanical ventilation and that had a complete recovery only after plasmapheresis.
La encefalomielitis aguda diseminada es una enfermedad infrecuente pero de elevada morbi-mortalidad en pacientes adultos. Demanda una sospecha y diagnóstico precoz que requiere el concurso de información clínica, pruebas de laboratorio y estudio de imágenes. De sustrato inmunológico, se puede relacionar a una infección viral, bacteriana o inmunización reciente. Los glucocorticoides son el tratamiento de elección, mientras que la inmunoglobulina intravenosa y la plasmaféresis se reservan para casos refractarios. Se presenta el caso de una encefalomielitis aguda diseminada grave, en un paciente de sexo masculino de 25 años, asociado a una infección respiratoria por virus parainfluenza 3. Requirió conexión a ventilación mecánica y tuvo una respuesta completa con plasmaféresis.
Subject(s)
Adult , Humans , Male , Encephalomyelitis, Acute Disseminated/virology , Respirovirus Infections/complications , Encephalomyelitis, Acute Disseminated/therapy , Magnetic Resonance Spectroscopy , Plasmapheresis , Respiration, Artificial , Respirovirus Infections/therapy , Severity of Illness IndexABSTRACT
Objective. The purpose of this study was to compare the intra-class correlation coefficients (ICC) and design effects (D) estimates adjusted or unadjusted for sensibility (Se) and specificity (Sp) of the diagnostic tests using a Bayesian procedure. Materials and methods. Sera from 232 animals from 44 randomly selected herds, to detect antibodies against parainfluenza-3 virus (PIV3) from non-vaccinated dual-purpose cattle from Colima Mexico, were used. Only 176 animals from 33 herds were used to evaluate the presence of the bovine respiratory syncytial virus (BRSV). Results. The ICC and D values adjusted and unadjusted for PIV3 were 0.33, 2.73, 0.32, and 2.71, respectively. For BRSV the values were 0.31, 2.64, 0.28 and 2.49. Conclusions. The adjusted or unadjusted ICC and D estimates were similar because of the high Se and Sp of the diagnostic tests and the relatively high prevalence of the diseases here studied.
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Subject(s)
Animals , Respiratory Syncytial Virus, BovineABSTRACT
Los virus parainfluenza del ser humano (VPIh) son patógenos importantes de enfermedad respiratoria en niños; pese a ello, existe escasa información publicada en Sudamérica dirigida a caracterizar esta infección. Objetivo: Describir las manifestaciones clínicas y epidemiológicas específicas de los VPIh en niños hospitalizados. Pacientes y Métodos: Se revisaron todas las hospitalizaciones respiratorias (HR) efectuadas en el Hospital de la Pontificia Universidad Católica, Santiago, Chile, durante el período 2001-2004 y sus respectivos estudios virales obtenidos de secreciones nasofaríngeas en aquellos con sospecha de infección viral. Resultados: Se identificaron 3.043 HR siendo 64 (2,1 por ciento) VPUrh La edad promedio fue 13 meses (rango: 1 m-12 a) siendo 77 por ciento) de edad inferior a dos años. VPIh-2 fue el serotipo prevalente (47 por ciento), observándose una tendencia estacional para los serotipos 2 y 3. Las presentaciones más frecuentes fueron sibilancias asociadas a virus (40 por cientoo) y neumonía (30 por ciento). Todas las bronquiolitis se presentaron asociadas a VPIh serotipos 2 y 3. Sólo 17 por ciento de los hospitalizados por VPIh+ (44 por ciento VPIh-1) desarrollaron laringitis. Conclusión: Virus parainfluenza humano puede ser responsable de HR en niños, mostrando una tendencia estacional VPIh-2 y el serotipo 3. Aunque son poco frecuentes como causa de HR, confirmamos su participación como etiología específica de laringitis, bronquiolitis y neumonía, especialmente en niños pequeños.
Background: Human parainfluenza viruses (hPIV) are a common cause of respiratory illness of children but published data on clinical characteristics of hPIV infection in South America is scarce. Objective: To review the clinical presentation and epidemiological features of hPIV in a series of hospitalized children in Chile. Patients and Methods: Retrospective review of clinical charts from all pediatric admissions with a diagnosis of respiratory disease (between January 2001 to December 2004) at the Catholic University Hospital, Santiago, Chile. Nasopharyngeal secretions were tested for hPIV in children admitted with suspected respiratory viral infections. Results: A total of 3,043 respiratory admissions were recorded during the study period; 64 children (2.1 percent) were hPIV positive. Average age was 13 months (range: lm to 12y) and 77 percent> were younger than 2 years. HPIV-2 was the most common type identified (47 percent). A seasonal trend was noted for serotypes hPIV-2 and 3. Acute wheezing (40 percento) and pneumonia (30 percent) were the most common clinical diagnosis in hPIV positive children and 17 percent> hPIV positive children (44 percent> for hPIV-1) were associated with laryngitis. All hPIV positive bronchiolitis were due to serotypes hPIV-2 and 3. Conclusion: hPIV can cause respiratory disease requiring hospitalization; serotypes hPIV-2 and 3 displayed a seasonal trend. Although hPIV is an uncommon cause of severe respiratory infecion requiring hospitalization in children, it should be considered in the differential diagnosis of laryngitis, bronchiolitis and pneumonia, especially in younger children.