바이러스성 크루프로 입원하는 소아 환자의 역학적 특성과 임상적 중증도 평가 = Epidemiology and Clinical Severity of the Hospitalized Children with Viral Croup

다국어 초록 (Multilingual Abstract)

Purpose: In this study, the clinical and epidemiological characteristics of patients admitted for viral croup were analyzed to evaluate disease severity based on the organism that caused the infection. Methods: We retrospectively reviewed the medical records of 302 patients who were admitted to the Department of Pediatrics at the Wonju Severance Hospital between May 2013 and December 2016 for viral croup. Patients who showed positive results on multiplex polymerase chain reaction were subsequently diagnosed with respiratory virus infection. The Westley scoring system was used to evaluate the severity of viral croup. Results: Of the 302 patients, 149 were admitted due to severe viral croup, including 88 boys and 61 girls, with a boy-to-girl ratio of 1.44:1. About 110 cases of parainfluenza virus infection have been reported, which accounted for almost half of the total cases. The other identified viruses included influenza virus, human rhinovirus, and respiratory syncytial virus. Analysis of the association between severe viral croup and causative pathogen revealed that only parainfluenza type 2 virus showed a significantly high risk. Parainfluenza type 2 virus did not show an age-based difference in frequency but showed relatively a higher frequency of infections during the summer and fall. Conclusions: In this study, parainfluenza virus type 2 was the only virus associated with severe viral croup. To facilitate proper preventive management, treatment, and prognosis evaluation of viral croup, prospective and multicenter studies should assess the additional variables and the severity of the virus. Additionally, further studies should be conducted to assess age-dependent influences, as well as the regional and seasonal incidence of viral infection.

참고문헌 (Reference)

1 김금향, "하기도 감염으로 입원한 소아에서 12종 바이러스의 검출 및 임상 양상" 대한소아과학회 51 (51): 834-841, 2008

2 염희연, "소아에서 human metapneumovirus 감염" 대한소아과학회 49 (49): 401-409, 2006

3 임정숙, "소아에서 13종 호흡기 바이러스에 의한 급성 하기도 감염의 임상 양상" 대한소아과학회 53 (53): 373-379, 2010

4 Kaditis AG, "Viral croup: current diagnosis and treatment" 17 : 827-834, 1998

5 Rosekrans JA, "Viral croup: current diagnosis and treatment" 73 : 1102-1106, 1998

6 Wall SR, "The viral aetiology of croup and recurrent croup" 94 : 359-360, 2009

7 Tuffaha A, "The role of respiratory viruses in acute and chronic asthma" 21 : 289-300, 2000

8 Williams JV, "The clinical presentation and outcomes of children infected with newly identified respiratory tract viruses" 19 : 569-584, 2005

9 Choi EH, "The association of newly identified respiratory viruses with lower respiratory tract infections in Korean children, 2000-2005" 43 : 585-592, 2006

10 Sung JY, "Role of human coronavirus NL63 in hospitalized children with croup" 29 : 822-826, 2010

11 Rihkanen H, "Respiratory viruses in laryngeal croup of young children" 152 : 661-665, 2008

12 Marx A, "Pediatric hospitalizations for croup (laryngotracheobronchitis): biennial increases associated with human parainfluenza virus 1 epidemics" 176 : 1423-1427, 1997

13 Knott AM, "Parainfluenza viral infections in pediatric outpatients: seasonal patterns and clinical characteristics" 13 : 269-273, 1994

14 Campbell AJP, "Nelson textbook of pediatrics" Elsevier 1603-1606, 2016

15 Westley CR, "Nebulized racemic epinephrine by IPPB for the treatment of croup: a doubleblind study" 132 : 484-487, 1978

16 Henrickson KJ, "National disease burden of respiratory viruses detected in children by polymerase chain reaction" 23 (23): S11-S18, 2004

17 Kim YK, "Human metapneumovirus-associated lower respiratory tract infections in korean infants and young children" 24 : 1111-1112, 2005

18 Han TH, "Human coronavirus-NL63 infections in Korean children, 2004-2006" 38 : 27-31, 2007

19 Chiu SS, "Human coronavirus NL63 infection and other coronavirus infections in children hospitalized with acute respiratory disease in Hong Kong, China" 40 : 1721-1729, 2005

20 Hindiyeh M, "Evaluation of a multiplex real-time reverse transcriptase PCR assay for detection and differentiation of influenza viruses A and B during the 2001-2002 influenza season in Israel" 43 : 589-595, 2005

21 Henrickson KJ, "Epidemiology and cost of infection with human parainfluenza virus types 1 and 2 in young children" 18 : 770-779, 1994

22 Osiowy C, "Direct detection of respiratory syncytial virus, parainfluenza virus, and adenovirus in clinical respiratory specimens by a multiplex reverse transcription-PCR assay" 36 : 3149-3154, 1998

23 Denny FW, "Croup: an 11-year study in a pediatric practice" 71 : 871-876, 1983

24 Johnson D, "Croup" 2009 : 0321-, 2009

25 Osmond M, "Croup" 319-329, 2002

26 Peltola V, "Clinical courses of croup caused by influenza and parainfluenza viruses" 21 : 76-78, 2002

27 Dawson KP, "Acute laryngo-tracheo-bronchitis (croup): an audit of hospital practice" 13 : 63-68, 1993

28 Syrmis MW, "A sensitive, specific, and costeffective multiplex reverse transcriptase-PCR assay for the detection of seven common respiratory viruses in respiratory samples" 6 : 125-131, 2004

29 van den Hoogen BG, "A newly discovered human pneumovirus isolated from young children with respiratory tract disease" 7 : 719-724, 2001