Research epidemiology, Clinical Manifestation and Laboratory Findings of Severe Adenovirus Pneumonia in the Intensive Care Unit of Thanh Hoa Pediatric Hospital

Objective: To describe the epidemiology, clinical manifestation and laboratory findings of severe adenovirus pneumonia in the ICU of Thanh Hoa Pediatric Hospital. Subject and Method: This is a descriptive study with the enrollment of 90 patients diagnosed with severe and very-severe adenovirus pneumonia form 11/2016 to 06/2018 in the ICU of Thanh Hoa Pediatric Hospital. Result: the male and female ratio is 5:1, under 12 months of age patients accounted for 84.4%. The infection was mostly happened in the healthcare facility at 56.7%. The majority of the patients had high grade fever (>39 o C) and lasted 7 days: 56.7% and 60%. 82.2% patients had symptoms of upper respiratory tract infection, 40% had gastrointestinal symptoms,16.7% and 8.7% had conjunctivitis and rash, respectively. Respiratory failure, crackles, hepatomegaly: 78.9%, 93.4% and 52.2% respectively. SIRS, septic shock, multiorgans failure: 78.9%, 52.2% and 34.4% respectively. Neutrophilia 32.2%, low hemoglobin count 72.2%, coagulation dysfunction 68.6%, elevated CRP (> 10 mg/dL) 80%, elevated procalcitonin (>0.05 ng/L) 96.7%, low total plasma protein (<55 g/L) 50%, low plasma albumin (≤ 35g/L) 74.4%, elevated GOT (≥100U/L) 53%. There was 81.3% of the patients had low oxygenated blood conversion rate. Decreased humoral immunity 29.4%, decreased cell-mediated immunity 84%. In conventional chest Xray, the most common findings were localized or diffused infiltrations: 42.2% and 46.7% respectively. Co-infection 43.3%; Co-CMV infection 74.5%, Co-EBV infection 22.2%. About 18.9% of the case had positive culture. Conclusion: mainly under 12 months of age children got infected with the most common source of infection is from the hospital. Prolonged length of stay.Unspecific signs and symptoms.Hypoxemia, high rate of co-infection. In Xray, main findings were diffuse infiltration or localized. The majoritiy of the patients had decreased cell-mediated immunity.