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Clinical Features, Virus Identification, and Sinusitis as a Complication of Upper
Respiratory Tract Illness in Children Ages 4-7 Years
#MMPMID26787374
DeMuri GP
; Gern JE
; Moyer SC
; Lindstrom MJ
; Lynch SV
; Wald ER
J Pediatr
2016[Apr]; 171
(?): 133-9.e1
PMID26787374
show ga
OBJECTIVE: To determine the rate of sinusitis complicating upper respiratory
tract illnesses (URIs) in children. We prospectively identified the clinical,
virologic, and epidemiologic characteristics of URIs in a population of 4- to
7-year-old children followed for 1 year. STUDY DESIGN: This was an observational
cohort study in 2 primary care pediatric practices in Madison, Wisconsin. Nasal
samples were obtained during 4 asymptomatic surveillance visits and during
symptomatic URIs. A polymerase chain reaction-based assay for 9 respiratory
viruses was performed on nasal samples. A diagnosis of sinusitis was based on
published criteria. RESULTS: Two hundred thirty-six children ages 48-96 months
were enrolled. A total of 327 URIs were characterized. The mean number of URIs
per child was 1.3 (range 0-9) per year. Viruses were detected in 81% of URIs;
rhinovirus (RV) was most common. Seventy-two percent of URIs were resolved
clinically by the 10th day. RV-A and RV-C were detected more frequently at URI
visits; RV-B was detected at the same rate for both asymptomatic surveillance
visits and URI visits. Sinusitis was diagnosed in 8.8% of symptomatic URIs.
Viruses were detected frequently (33%) in samples from asymptomatic children.
CONCLUSIONS: Sinusitis occurred in 8.8% of symptomatic URIs in our study. The
virus most frequently detected with URIs in children was RV; RV-A and RV-C
detection but not RV-B detection were associated with illness. Viruses,
especially RV, are detected frequently in asymptomatic children. Most URIs have
improved or resolved by the 10th day after onset. Children experienced a mean of
1.3 URIs per year, which was lower than expected.
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