title: Survey of severe respiratory syncytial virus infection in Kyoto Prefecture from 2003 to 2007.
abstract: BACKGROUND
  Respiratory syncytial virus (RSV) infection in infants can develop into a severe condition.
  
  
  METHODS
  A survey of patients with severe RSV infection in hospitals in Kyoto Prefecture was performed from 2003 to 2007. Patients requiring intubation and those with cardiopulmonary arrest on arrival (CPAOA) were considered to have severe RSV infection.
  
  
  RESULTS
  Twenty-five patients with severe infection were identified and detailed data were available for 21 patients, of whom 18 required intubation and three had CPAOA. The male/female ratio was 12/9 and age ranged from 8 days to 19 years (average, 5.2 months; median: 2 months). At admission white blood cell count, lactate dehydrogenase (P < 0.05), and blood glucose (P < 0.01) were higher and Na was lower (P < 0.01) in the 18 patients with severe infection (excluding the CPAOA cases) compared to 18 sex- and age-matched patients with mild RSV infection. The incidence of bacterial infection was also higher in severe cases (P < 0.05). The outcome was death in four patients (19.0%, including two sudden deaths), aftereffects in two (9.5%), hospital discharge with improvement in 14 (66.7%), and an unclear outcome in one patient. Excluding the two sudden death cases, 14 of 19 patients (73.7%) were extubated within 2 weeks. The period of intubation was longer in older patients (P < 0.05).
  
  
  CONCLUSIONS
  Because severe RSV infection led to sudden death in two cases, detection of RSV is important at admission for an infant with CPAOA. Fourteen patients (66.7%), however, had good outcomes and most patients were extubated within 2 weeks.
authors.affiliation: Department of Pediatrics, Nantan General Hospital, Yagiueno25, Yagi-town, Nantan city, Kyoto 629-0197, Japan. hisato527@leto.eonet.ne.jp
authors.forename: Hisato
authors.initials: H
authors.lastname: Ito
authors.forename: Toshio
authors.initials: T
authors.lastname: Osamura
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Nakajima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fujiwara
authors.forename: Yasumichi
authors.initials: Y
authors.lastname: Kuwabara
authors.forename: Toru
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yasuno
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Komatsu
authors.forename: Zenrou
authors.initials: Z
authors.lastname: Kizaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Kishida
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Akiyama
authors.forename: Tadaki
authors.initials: T
authors.lastname: Oomae
authors.forename: Kouji
authors.initials: K
authors.lastname: Nakajima
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Nakamura
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kiyosawa
authors.forename: Ryuta
authors.initials: R
authors.lastname: Nisikomori
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors