Çocukluk Çağı Alt Solunum Yolu Enfeksiyonlarında Yeni Etkenler

Abstract

Çocukluk çağının en sık enfeksiyon grubunu oluşturan alt solunum yolu enfeksiyonlarından (ASYE) sıklıkla viral etkenler sorumlu tutulur. Bunlar arasında Influenza, Parainfluenza, Adenovirüsler ve Respiratuar sinsityel virüs (RSV) yer alır. Son yıllarda, ASYE bulguları olanlarda metapnömovirüs, avian influenza A, H5N1, SARS coronavirüs gibi yeni etkenler saptanmıştır. Paramiksovirüs ailesinden bir RNA virüs olan metapnömovirus, özellikle tropikal ülkelerde ilkbahar ve yaz aylarında sık saptanır. Hem üst hem de alt solunum yolunu ilgilendiren bulgular ile ortaya çıkabilir. RNA virüsü olan Coronavirüsler, sıklıkla ASYE, daha nadiren ise ÜSYE bulguları ile ortaya çıkabilir. SARS (Severe acute respiratory syndrome-ağır akut solunum yetmezliği sendromu), corona virüs ailesine aittir. Küçük DNA virüslerden olan polyomavirüsler ise, asemptomatik gidişten ağrı ASYE bulguları olan klinik tabloya kadar geniş bir yelpazeye neden olurlar. Bocavirusler ise parvovirüs ailesinden olan alt solunum yolu enfeksiyon etkenleridir. İnfluenza ise, H1N1 ve H5N1 gibi farklı serotipleri nedeni ile epidemi ve pandemi nedeni olabilen solunum yolu enfeksiyon etkenidir.Sonuç olarak, ASYE’larının klinik bulguları ve prognozu çoğunlukla nonspesifik olmakla birlikte, etiyolojik etken ile ilişkilidir. Bu nedenle, etken olan ajanlarla ilgili prevalans ve insidansın daha net olarak ortaya çıkarılması için çalışmalara gereksinim vardır.

Keywords

• solunum yolu enfeksiyonu, influenza, metapnömovirus, coronavirüsler, bocavirüs, polyomavirüs

NEW ETIOLOGICAL AGENTS OF CHILDHOOD LOWER RESPIRATORY TRACT INFECTIONS

Abstract

Viral etiological agents are commonly encountered in lower respiratory tract infections (LRTI) that comprise the most common infectious disease group of childhood. These agents include Influenza, Parainfluenza, Adenoviruses and Respiratory syncitial viruses (RSV). Recently, new etiological agents such as metapneumovirus, avian influenza A, H5N1 and SARS coronaviruses have been detected in children with LRTI findings. Metapneumovirus, which is an RNA virus member of the Paramyxovirus family, is commonly encountered in tropical countries during spring and summer. It might present with symptoms involving both upper and lower respiratory tract. Coronaviruses that are RNA viruses present commonly with LRTIs but rarely may cause upper respiratory tract findings. SARS (Severe acute respiratory syndrome) belongs to the corona virus family. Polyomaviruses that are small DNA viruses cause a wide spectrum of clinical findings that range from aseymtpomatic infection to severe LRTI findings. Bocaviruses from Parvovirus family are other LRTI etiologic agents. Influenza viruses are LRTI agents that may lead to epidemics and pandemics due to their different serotypes like H1N1 and H5N1. In conclusion, clinical findings and prognosis of LRTIs, though usually nonspecific, depend on the etiological agent. Therefore, further research is required to identify prevalence and incidence of these etiological agents

Keywords

• Lower respiratory tract infection, influenza, metapneumovirus, coronavirus, bocavirus, polyomavirus

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