Clinical Analysis Of Cytomegalovirus Pneumonia In Children

Objective:To analyze the clinical,laboratory,radiological and treatment characteristics of cytomegalovirus pneumonia in children.Methods:The clinical data of children who are in accordance with cytomegalovirus pneumonia were collected from January 2016 to December 2017 in the Department of Respiratory in the Children’s Hospital of Suzhou University.And 25 children with non-cytomegalovirus pneumonia enrolled in the same period were as the control group.Analyze all the clinical features,laboratory tests,imaging data and the treatment of children.Results:1.25 cases of cytomegalovirus pneumonia in children,23 cases(92%)are ≤6 months old,and the children who are ≤3 months old、non artificial feeding and eutocia were more than those in the control group.2.The incidence in the study group children was highest in the spring(9 cases,36%),and in the other three seasons was lower.3.The occurrence of cough,fever,tachypnea,physical signs of lung,laryngeal or tracheal malacia and basic diseases in the study group children compared with the control group had no statistical difference(P > 0.05).But the occurrence and variety of extrapulmonary complication especially the liver dysfunction is significantly more than those in the control group.4.The WBC count,ALT,AST,LDH and CD3+CD8+ proportion in the study group were significantly higher than those in the control group,but the CD3+CD4+ proportion and CD4+/CD8+ were lower than the control group.5.The relevance of BAL and blood CMV PCR values is low(R=0.130,P=0.659).Between the CMV Ig M positive and non-positive groups,the BAL and blood CMV PCR values had no statistical difference.6.The main finding of chest X-ray or CT in the cytomegalovirus pneumonia in children was bilateral infiltration with small patchy and maculas shadows,and 4 cases characterised by interstitial change in the lung.7.Taking the measure with supporting therapy routinely,ganciclovir against CMV and combined with IVIG as necessary,the state of illness in the children had been better,but 4 cases of granulopenia happened,no other side effects were found.Conclusions:1.The cytomegalovirus pneumonia in children mostly strike the infant ≤6 months old,especially ≤3 months old,having protracted course of disease prior to admission,and a long-term hospitalization.2.Most children have extrapulmonary complication especially the liver dysfunction and may combined with abnormal LDH and AST.The disorders in the cellular immunity can exist in these children at the same time,and in severe case can cause the inversion of CD4+/CD8+ ratio.3.The blood CMV PCR and CMV-Ig M serologic tests can not replace the test of BAL CMV PCR.4.Taking the measure with ganciclovir against CMV,combined with immunoregulation as necessary and supporting therapy is safe and efficient for the cytomegalovirus pneumonia in children,but still need to be on guard against the side effects of ganciclovir.