Human bocavirus and other respiratory viral infections in a 2-year cohort of hospitalized children.

Human bocavirus (HBoV) infection is reported worldwide and may cause severe respiratory tract infections. The aim of the present study was to assess the prevalence of HBoV, and other respiratory viral pathogens, in a 2-year retrospective study of children admitted to hospital, and to investigate whether viral loads of HBoV DNA were associated with severity of infection. Between April 2007 and March 2009, 891 respiratory samples from 760 children admitted to hospital with acute respiratory tract infection were tested for the presence of respiratory viruses by real-time PCR or direct immunofluorescence testing. HBoV DNA was detected by using internally controlled real-time quantitative PCR assay and 25 samples selected at random were sequenced. The virus detected most frequently was rhinovirus, followed by respiratory syncytial virus, HBoV, and human metapneumovirus. HBoV DNA was detected in 18.4% of children admitted to hospital. HBoV was the only viral pathogen detected in 66/164 (40.2%) of HBoV DNA-positive children and in 7.4% of all 891 samples. Ninety-seven percent (64/66) of children with an HBoV single infection were diagnosed as having lower respiratory tract infection. Median HBoV DNA viral load was significantly higher in children when HBoV was detected as a single pathogen. Higher HBoV DNA viral loads were associated with prematurity and age. HBoV seems to be an important and frequent pathogen in respiratory tract infections in children, and it is likely that the severity of illness is comparable to the severity of RSV illness.

Epiglottic suture for treatment of laryngomalacia.

OBJECTIVES: To present a technique for surgical management of laryngomalacia directed against the basic abnormality of the disease. Considering the cause-consequence relations of the abnormalities, we can distinguish two types of laryngomalacia. In the first, the basic abnormality is the pathological shape of the epiglottis: the epiglottis, which normally stands in an upright position, is characteristically excessively folded, restricting the supraglottic space directly as well as indirectly due to the proximity of the aryepiglottic folds that are attached to its lateral edges. In the second type the abnormality is the backward displacement (ptosis) of a normally shaped epiglottis. All other abnormalities are the consequences of these basic abnormalities. We present a new procedure, the epiglottic suture, to correct the pathological shape of the epiglottis. It is a suture placed transversely on the lingual surface of the epiglottis that unfolds the folded epiglottis and shifts apart the adjacent aryepiglottic folds. PATIENTS AND METHODS: Prospective non-randomized study performed on eight severely distressed patients with laryngomalacia at the University Department for Otorhinolaryngology and Cervicofacial Surgery, Ljubljana, Slovenia. RESULTS AND CONCLUSION: The epiglottic suture enabled normal breathing in all treated children without compromising the airway-protection function of the epiglottis. After an average follow up time of 19.12 months (minimum 7 months and maximum 27 months), we have not noticed any complications or deteriorations of breathing.