RESPIRATORY AND SYNCYTIAL INFECTION

From Big Medical Encyclopedia

RESPIRATORY AND SYNCYTIAL INFKKTION (Latin respiratio breath; lat. syncytium sincytium; late lat. infectio infection) — one of respiratory viral diseases, at a cut are surprised respiratory organs, preferential their lower parts, with frequent development of bronchitis, bronchiolites, pneumonia.

An etiology

the Disease-producing factor — a respiratory and syncytial virus. It is allocated in 1956 by A. Morris and soavt. The respiratory and syncytial virus contains RNA, enters in a row metamyxoviruses of family of paramyxoviruses (see. Paramyxoviruses ). Characteristic property of this virus is ability to cause formation of a sincytium or pseudogiant cells in culture of cells.

Epidemiology

R. - page and. it is widespread everywhere, is registered all the year round, however its flashes arise more often in the winter and in the spring. It is transferred in the airborne way. A source of an infection is the sick person, to-ry allocates a virus within 10 — 14 days. Children of chest age are most susceptible to a contagium. At a drift of this infection in child care facility practically all children aged up to one year who were in contact with the patient get sick.

In a pathogeny of a disease the air hunger resulting from diffusion obstructive process in bronchial tubes is of great importance. Blood serum of most of newborns contains the antibodies received from mother to a respiratornosintsitialny virus, to-rye disappear at the age of 3 — 4 months. During this period there is primary infection of the child. From now on children become especially susceptible to respiratory syncytial virus. R.'s disease - page and. at the age of 1 — 2 years consider already as reinfektssho. At children of preschool and younger school age the largest content of antibodies to respiratory syncytial virus is noted.

The pathological anatomy

the Respiratory and syncytial virus breeds in cells of an epithelium of respiratory tracts, in to-rykh there are multinuclear sosochkovidny outgrowths occupying sometimes a considerable part of a gleam of a bronchial tube. Sosochkovidny growths can be also in alveoluses. The most expressed changes arise in small bronchial tubes and bronchioles, the gleam to-rykh is almost completely closed by viscous slime. In pulmonary fabric melkoochagovy atelectases and emphysema are found.

Clinical picture

Incubation interval from 3 to 7 days. A wedge, manifestations can vary from very easy damages of upper airways to heavy bronchiolites, bronchitis (see. Bronchitis ) and pneumonia (see. Pneumonia ).

At children of advanced age and adults the disease usually proceeds easily — in the form of acute Qatar of upper respiratory tracts without temperature increase or with a subfebrile temperature. The general state worsens slightly. Duration of a disease from 2 to 10 days.

The most severe forms of a disease are observed at children aged up to one year. The disease at them develops usually gradually. To the phenomena rhinitis (see) cough, sometimes pristupoobrazny joins. Temperature can be subfebrile in the beginning. The aggravation of symptoms comes in 2 — 3 days or later in connection with involvement in process of bronchial tubes and lungs. Weight of a condition of the child in this case is caused not by the general intoxication, and respiratory insufficiency (see). The leading symptom is asthma (see), preferential expiratory character, at the same time retractions of compliant places of a thorax are sometimes observed. A lot of scattered small-bubbling wet rattles is listened, emphysema of lungs accrues, cyanosis develops. The picture of an obstructive syndrome develops. In such cases it is difficult to exclude pneumonia, edges at children of chest age can arise along with a bronchiolitis. In some cases at R. - page and. the syndrome can develop grain (see).

Complications otitis (see), focal pneumonia, as well as at other acute respiratory viral diseases, are caused by accession of a consecutive microbic infection.

The diagnosis

Existence of a bronchiolitis and obstructive syndrome, absence of intoxication, low temperature with the expressed respiratory insufficiency allow to suspect R. - page and. Epidemiological data (bystry spread of a disease in the center of an infection and defeat of all children aged up to one year) help to make the diagnosis.

Allocation of a virus from washouts of a nasopharynx, increase in pair serums of complement-linked and virus neutralizing antibodies is undoubtedly confirmed by a wedge, the diagnosis, but this diagnosis is retrospective.

Treatment

Treatment generally symptomatic, depends on disease severity. At the expressed concern of the child appoint sedative drugs (Pipolphenum intramusculary of 1 — 3 mg/kg of body weight a day, etc.); at the phenomena of cardiovascular insufficiency — cardiac glycosides; at a combination of an obstructive syndrome to pneumonia therapy is shown by antibiotics and steroid hormones. From the first days of a disease introduction to a nose of interferon is recommended.

The forecast and Prevention

the Forecast at timely treatment favorable.

Prevention. Specific prevention is not developed.

See also Respiratory viral diseases .



Bibliography: Dreyzin R. S. Respiratory and syncytial viral infections, JI., 1968; Freeman G. L. and. Todd R. N of The role of allergy in viral respiratory tract infections, Amer. J. Dis. Child., v. 104, p. 330, 1962; Mitchell I., Inglis H. Simpson H. Viral infection in wheezy bronchitis and asthma in children, Arch. Dis. Childh., v. 51, p. 707, 1976; Rooney J. C. a. Williams H. E. The relationship between proved viral bronchiolitis and subsequent wheezing, J. Pediat., v. 79, p. 744, 1971.


H. I. Nisevich.

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