[Bronchopneumonia, obstructive bronchitis and bronchiectasis in children with adenovirus infections]. / Bronhopneumonije, opstruktivni bronhitis i bronhiektazije u djece s adenovirusnim infekcijama.

During the five-year period 56 children were treated in hospital due to respiratory infections caused by adenovirus. Clinical, laboratory and radiographic signs of the illness are presented. The infections manifested as the upper respiratory tract infection in 3 patients (5.4%), obstructive bronchitis in 16 patients (28.6%), bronchopneumonia in 32 patients (57.1%) and bronchiectasis in 5 patients (8.9%). Three children were operated: bilobectomy was performed in two cases, and left-sided pulmonectomy in one case. Histologically, bronchiectasis was found in two cases and bronchiolitis obliterans in one case. In this work we tried to show the gravity, importance and consequences of the adenoviral infection of the respiratory tract in children.

[Legionnaires' disease in children]. / Legionarska bolest u djece.

During the first nine months of 1987, the bacteriological and virological tests as well as the indirect fluorescence test to Legionella pneumophila were performed in 40 children with bronchopneumonia (one- or both-sided) or pleuropneumonia and in 10 children with protracted bronchitis. In a 15 month old boy we have proved (by titer dynamics) the infection with Legionella pneumophila serotype 5, and in a 15 month old girl and in a 16 month old boy serotype 1. The infection was sporadic and the possible source of infection was unknown. The course of the disease was not wasting and the infection was accompanied with fever. The patients had an increased sedimentation rate of red cells and leukocytosis. All the other laboratory findings were within normal limits. In seven children seropositiveness 1:256 to Legionella pneumophila serotype 1, and in two children an increased titer to adenovirus was proved. The high titer to Legionella pneumophila in those seven children indicates an early contact with the causal agent. The patients were successfully treated with cefuroxim, which is not the drug of choice. Infection due to Legionella pneumophila in children does not exhibit a clinical or laboratory characteristic features that differ from those of the other respiratory diseases in children. It means that Legionnaires' disease in children with intact immunity is not the wasting illness. We stress the importance of using serologic examination to Legionella pneumophila as a routine procedure in the aetiological diagnosis of respiratory diseases in children.

[Primary ciliary dyskinesia]. / Primarna cilijarna diskinezija.

The immotile cilia syndrome is a genetic disease characterized by chronic disease of the upper and lower respiratory tract, male infertility and situs viscerum inversus in 50% of affected patients. Abnormalities of ciliary structure are the cause of abnormalities in mucociliary clearance and chronic inflammation consecutively. The boy aged 13 years with clinical manifestations (chronic rhinorrhea, sinuitis, recurrent otitis media, recurrent bronchial inflammation, pneumonia and finally bronchiectasis) has been presented. The boy had a normal visceral status. The diagnosis was confirmed by electron microscopy analysis of cross section of bronchial cilia: numerous abnormalities in microtubules positioning and lack of radiar arms have been found.