Background: Human Rhinoviruses are among the most common causes of acute respiratory illnesses in children involving both the upper and lower respiratory tract (LRT). Clinical spectrum ranges from mild flu like illness to severe respiratory compromise necessitating intensive care (ICU) admission.
Objectives: To evaluate the clinical spectrum of Rhinoviral infections in hospitalized children in Israel.
Methods: Between 01/07/2011 -30/06/2012, respiratory samples from all children (age < 5 years) hospitalized with acute respiratory illness at Sheba Hospital were tested for rhinovirus and other respiratory viruses by Real Time RT-PCR and sequencing. Patients` background, signs and symptoms, laboratory data, imaging and treatment were recorded from patient charts.
Results: 243 children tested positive for Rhinovirus. The most common species found was type A (53%). Rhinovirus was perennially detected. In 44% a viral co-Infection, most commonly adenovirus was present. 58% had significant co-morbid chronic illness. Common symptoms were cough (67%), rhinorrhea (59%), shortness of breath (44%), and decreased appetite (39%). Abnormal breathing sounds were found in 55% of patients. 21% were admitted to ICU. Laboratory data showed monocytosis in 51%, hypercalcemia in 61% (findings not previously reported). Chest X ray was performed in 66% of the patients, of them 59% had pathological findings. 63% received antibiotic treatment, 60% needed inhalations, 42% received systemic steroids. LRT involvement was identified in 75% of patients.
Conclusion: Rhinovirus infections pose an extensive burden of respiratory illness in hospitalized children. Lower respiratory tract involvement is more common than that reported in the literature. Associated hypercalcemia is a new finding, as yet, unexplained.
