Viral infections in children

Asthma Adverse reactions occurring in more than 3% of patients include headache and influenza. In children 6 to 14 years of age, the following events occurred with a frequency of 2% Diarrhea, laryngitis, pharyngitis, nausea, otitis, sinusitis, viral infections. In children 2 to 5 years of age the following events occurred with a frequency of 2% Rhinorrhea, otitis, ear pain, bronchitis, leg pain, thirst, sneezing. 

Breese Hall C, Powell KR, MacDonald NE et al (1986) Respiratory syncytial viral infection in children with compromised immune function. New Engl J Med 315 77-81... 

The antipyretic dose of salicylate for adults is 325-650 mg orally every 4 hours. Salicylates are contraindicated for fever associated with viral infection in children fornonviral etiologies, 50—75 mg/kg/day has been given in 4-6 divided doses, not to exceed a total daily dose of 3.6 g. The rectal administration of aspirin suppositories may be necessary in infants or when the oral route is unavailable. 

In most of the world, HBV is the most common cause of acute viral hepatitis. As with HAV, most infections in children are clinically silent. An estimated 30% to 50% of adolescents and adults with acute HBV infection develop jaundice. The outcome in acute HBV infection is strongly influenced by age and immune status. In healthy adolescents and adults, an estimated 1% to 3% of cases will progress to chronic infection. In a person with immunosuppression, the likelihood of chronic infection increases to 10%. Neonates infected with HBV have a 90% likelihood of chronic infection, and the risk falls gradually over the first 5 years of life. 

Sinusitis is diagnosed more frequently in children than in adults. Typical clinical presentation and diagnosis of bacterial sinusitis are illustrated in Table 107-4. Between 5% and 13% of viral upper respiratory tract infections in children are complicated by bacte-... 

Still, there is a clear relation to viral infection in many cases of LIP, especially in children. In fact, there appears to be an association between LIP and several different viral infections. The culprits include Epstein-Barr virus (EBV), HIV-1, and human herpes virus-8 (HHV-8). 

Gendelman HE, Baca LM, Turpin J, Kalter DC, Hansen B, Orenstein JM, Dieffenbach CW, Friedman RM, Meltzer MS (1990) Regulation of HIV rephcation in infected monocytes by IFN-alpha. Mechanisms for viral restriction. J Immunol 145 2669-26676 Giovannini M, Zuccotti GV, Biasucci G, Locatelh V, Riva E (1992) Combined zidovudine and interferon-alpha 2a therapy in children with acquired immune deficiency syndrome. J Int Med Res 20 295-301... 

Otitis media, or inflammation of the middle ear, is the most common reason for prescribing antibiotics in children. It usually occurs after a viral infection of the nasopharynx and can be subclassified as acute otitis media or otitis media with... 

Multiple factors play a role in the development of AOM. Viral infection of the nasopharynx impairs eustachian tube function and causes mucosal inflammation, impairing mucociliary clearance and promoting bacterial proliferation and infection. Children are predisposed to AOM because their eustachian tubes are shorter, more flaccid, and more horizontal than adults, which make them less functional for drainage and protection of the middle ear from bacterial entry. Clinical signs and symptoms of AOM are the result of host immune response and damage to cells caused by inflammatory mediators such as tumor necrosis factor and interleukins that are released from bacteria.4... 

Reye s syndrome A sudden, sometimes fatal, syndrome characterized by encephalopathy and liver degeneration it occurs in children after viral infection and may be associated with aspirin use. 

Chickenpox Chickenpox is a highly contagious viral infection that causes rash-like blisters on the skin surface and mucous membranes. It is generally mild and not normally life-threatening. For adults, the symptoms are more serious and uncomfortable than for children. The disease can also be deadly for some people, such as pregnant women, people with leukemia, or immunosuppressed patients. Varivax (varicella virus vaccine live) from Merck Co. was tested on about 11,000 children and adults and was approved by the FDA in March 1995 as a chickenpox vaccine. 

The toxicity of ammonia was dramatically demonstrated by experiments carried out as early as 1931 injection of the enzyme urease, which catalyses the conversion of urea to ammonia, into rabbits rapidly caused their death. The normal concentration of ammonia in blood is about 0.02 mmol/L toxicity becomes apparent at a concentration of abont 0.2 mmol/L or above (see Table 10.1). Ammonia toxicity in very young children is usually associated with vomiting and eventually coma. It is almost invariably due to the deficiency of an enzyme of the urea cycle (see below). In adults, ammonia accnmulation, and hence toxicity, usually results from damage to the liver caused by poisons, alcohol or viral infection. 

Reye syndrome Do not use in children or teenagers with viral infections with or... 

This condition is sometimes mistaken for Reye syndrome, a severe disorder that develops in children while they appear to be recovering from viral infections such as chicken pox or flu. Most cases of Reye syndrome are associated with the use of aspirin during these viral infections. 

Recommended antipyretics are paracetamol, acetylsalicylic acid and short acting NSAIDs to adults. Children under the age of 18 should not be treated with acetylsalicylic acid due to an increased risk of Reye s syndrome in viral infections. 

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