The Clinical And Imaging Features Of Adenovirus Pneumonia In Children:an Retrospective Analysis In147Cases

Objective:To explore the clinical,chest X-ray and chest CT features of adenovirus pneumonia in children in order to enhance the diagnostic ability.Methods:A total of147patients who were comfirmed adenovirus pneumonia in our hospital from April2010to April2011were enrolled(common type:severe type=91:56),All the immunofluorescence results of the147children showed that the exfoliated nasopharyngeal cells from the147children were all adenovirus antigen positive.All the severe type children reached the diagnostic criteria of severe pneumonia by the respiratory group in the pediatric branch of the Chinese Medical Association.113children underwent chest X-ray,in which42followed up twice or above;82cases underwent chest CT,in which26followed up twice or above.All the clinical materials,chest X-ray and chest CT manifestations were retrospectively analyzed. Results:1.Epidemic features of adeno virus pneumonia:Of the147cases,there were97males and50females with the ratio of1.9:1,the ages ranged from13days to10years and7months,138(93.1%) occurred in children≤5years of age,and88(59.9%) occurred in children6months～2years of age.There was an epidemic peak in the winter,2010.2.Clinical features:140(95.2%) had fever,and121(82.3%) occurred hyperpyrexia.The mean duration of fever was10.39±6.75days.Adeno virus pneumonia usually caused damages of multisystem,the ratios of toxic myocarditis,encephalopathy,hepatitis in the severe group were higher than the common group(x2=7.302,17.238、5.106, P<0.05).3.Cheat X-ray manifestation showed that interstitial changes were observed in92.0%cases(104/113).The main consolidations were small lobe infiltrations which were observed in66.4%cases(75/113),these small lobe infiltrations were usually bilateral involved.Segmental or lobar infiltrations were observed in48.7%(55/113).Left lower lobes were the most commonly involved,followed by right upper lobes,left upper lobes were the least involved.12(10.6%) occurred atelectasis.Pleural thickening were observed in6cases and pleural effusion in7.4.Chest CT features:Multiple clustered consolidations were the main manifestation of severe adeno virus pneumonia. This kind of consolidations were usually distributed near the center,and with the features of high density, blur edged,uniform contrasted.The ratio of small airway changes in severe group were higher than that in common group(x2=12.094, P<0.05).Conclusion:1.There was an epidemic peak of adenovirus pneumonia in the winter,2010.Adenovirus pneumonia are more common in children less than5years old,and with the traits of long duration of fever and hyperpyrexia. Severe adenovirus pneumonia usually caused damages of multisystem.2. In chest X-ray the interstitial changes were common,and the main consolidations were small lobe infiltration and segemental or lobar infiltration.Left upper lobes were the least involved.Both pleural thickening and pleural effusion were rare.3.Multiple clustered consolidations in CT were the main manifestation of severe adenovirus pneumonia.This kind of consolidation usually distributed near the center,and with the features of high density,blur edged,uniform contrasted. Small airway changes were more common in the severe cases.Doctors should be vigilant against bronchiolitis obliterans when small airway changes are observed.