Is community acquired alveolar pneumonia (CAAP) with Adenovirus different than with RSV?

Shalom Ben Shimol ¹ Morad Uda ¹ Adi Klein ² David Greenberg ¹

¹Pediatric Infectious Diseaes Unit, Soroka University Medical Center
²Pediatrics, Hille Yaffe

Background: Adenoviruse (AdV) and RSV are common causes of lower respiratory tract infections. Radiographic confirmed CAAP is considered as bacterial infection. The aim of the present study was to determine if AdV -CAAP has different characteristics than RSV-CAAP.

Materials and methods: This was a retrospective analysis of all hospitalized children with chest x-ray diagnosed CAAP. Children with AdV or RSV detected by a PCR from nasal washes were included.

Results: Of 2,763 children with CAAP, AdV and RSV were detected in 70 (2.5%) and 939 (34.0%), respectively.

Comparison of children with AdV-CAAP- vs. RSV -CAAP-:

	AdV-CAAP (n=70)	RSV-CAAP (n=993)	p
Age (months±SD)	16.4±12.9	8.2±10.1	<0.001
Male (n [%])	45 (64.3%)	482 (51.3%)	0.04
Bedouins (n [%])	46 (65.7%)	658 (70.1%)	0.443
Asthma (n [%])	18 (29.5%)	80(12.0%)	<0.01
Chronic lung dis. (n [%])	12 (17.1%)	96 (10.2%)	0.07
Vomiting	28 (43.8%)	230 (30.8%)	0.03
Diarrhea	7 (11.3%)	31 (4.4%)	0.03
Temperature (mean Celsius±SD)	39.4±0.93	38.5±1.1	<0.001
Saturation (mean %±SD)	92.9±4.9	90.7±5.1	<0.001
Resp. Rate (mean breaths/minutes ± SD)	52.9±16.0	61.3±14.6	<0.001
CRP (mean mic/dl ± SD)	0.36±0.49	0.28±0.45	0.36
Leukocytes (mean 10³ cells/ml ± SD)	18.8±9.8	13.5±5.8	<0.001
Neutrophils (mean %±SD)	63.1±14.0	50.95±15.9	<0.001

Conclusions: Children with AdV-CAAP were older, had higher temperature and more gastrointestinal symptoms, higher leukocytes and neutrophils counts and lower respiratory rates compared with RSV-CAAP patients.

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