Evaluation of Patients with PCR-Positive Influenza Virus on Nasopharyngeal Specimens for Complications and Hospitalization

Yıl 2017, , 18 - 23, 01.01.2017

Murat Sütçü Manolya Acar Hacer Aktürk Selda Hançerli Törün Metin Uysalol Sevim Meşe Nuran Salman Ayper Somer

https://doi.org/10.5222/j.child.2017.018

Öz

Objective: Influenza is usually an acute self-limiting disease, though it can cause serious complications in high-risk patients. In this study the patients diagnosed as influenza infection during the year 2014 were investigated, and evaluation of the differences between patients followed up on an outpatient basis, and those requiring hospitalization.Material and Method: Forty- eight patients diagnosed as influenza based on PCR- positive nasopharyngeal smears obtained from patients followed up as an inpatient or on an ambulatory basis according to their clinical status and hospitalized patients in Istanbul University, Faculty of Medicine, Department of Children’s Health and Diseases between January2014-December 2014 were included in the study. Patients’ medical records and laboratory analysis were retrospectively analyzed.Results: Median age of the patients female, n=16, 33.3% was 54 months 4-204 months . The median age of hospitalized patients [n=22, 45.8%, median 43.5 months, 4-204 months ] was statistically smaller than the median age of ambulatory patients [n=26, 54.2%, median 92.5 months, 4-204 months ] p=0.002 . Fever was the most common presenting symptom n=38, 79,2% . Twenty-five patients 52.1% had chronic diseases with the most common one being asthma n=5, 10,4% . Only one patient 2.1% had influenza vaccination. Influenza types were H1N1 43,8% , H3N2 27,1% and Influenza B n=14, 29,2% . Neutropenia was the most common pathologic laboratory finding n=8, 16,7% . Median hemoglobin value of the hospitalized cases [median 11,7 gr/dL 7,4-1,3 gr/dL ] was significantly lower than that of the patients followed up on an ambulatory basis [median 12,4 gr/dL, 9,9-14,6 gr/dL ] p=0,02 . In total, median duration of the disease was 10 days 7-21 days . A patient 2,1% with the diagnosis of chronic liver disease died secondary to acute respiratory distress syndrome.Conclusion: In order to decrease complications and hospitalization rates related to influenza, small children and the patients with chronic disorders should be vaccinated

Anahtar Kelimeler

Influenza, child, complication

Nazofarengeal Sürüntü Örneklerinde PCR ile İnfluenza Virüsü Saptanan Vakaların Hastane Yatışı ve Komplikasyon Gelişimi Açısından Değerlendirilmesi

Öz

Amaç: İnfluenza; sıklıkla akut, kendini sınırlayan bir hastalık olmakla birlikte, özellikle risk grubundaki hastalarda komplikasyonlarla seyredebilmektedir. Çalışmamızda 2014 yılı boyunca influenza tanısı alan vakalar incelenmiş ve ayaktan izlenen hastalar ile hastane yatışı gerektiren vakalar arasındaki farkların değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Çalışmaya, İstanbul Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Kliniği’nde Ocak-Aralık 2014 tarihlerinde, nazofarengeal sürüntü örneklerinde PCR inceleme ile influenza tanısı alan ve klinik durumuna göre ayaktan ya da yatarak izlenen 48 çocuk vaka dahil edildi. Hasta dosyaları, laboratuvar tetkikleri ve epikrizleri retrospektif olarak incelendi.Bulgular: İnfluenza tanılı 48 hastanın kız, n=16, %33.3 yaş ortalaması 54 ay 4-204 ay idi. Hastaneye yatırılan hastaların n=22, %45.8 ortalama yaşı [ortanca 43.5 ay, 4-204 ay ], ayaktan izlenen hastaların n=26, %54.2 ortalama yaşından [ortanca 92.5 ay, 4-204 ay ] anlamlı olarak küçük bulundu p=0.002 . En sık kliniğe başvuru yakınması ateşti n=38, %79.2 . Hastaların %52.1’inde n=25 , başta astım n=5, %10.4 olmak üzere eşlik eden kronik hastalık mevcuttu. Yalnızca 1 hasta %2.1 aşılanmıştı. Yirmi bir hastada %43.8 H1N1, 13 hastada %27.1 H3N2 ve 14 hastada %29.2 İnfluenza B virüsü tespit edildi. En sık laboratuvar bulgusu nötropeni n=8, %16.7 idi. Hastaneye yatırılan vakaların ortalama hemoglobin düzeyi [ortanca 11.7 gr/dL 7.4-13 gr/dL ] ayaktan izlenen hastalara göre [ortanca 12.4 gr/dL, 9.9-14.6 g/dL ] anlamlı ölçüde düşük bulundu p=0.02 . Tüm hastalarda ortalama hastalık süresi 10 gün 7-21 gün idi. Kronik karaciğer hastalığı olan bir vaka %2.1 ARDS nedeniyle kaybedildi.Sonuç: İnfluenzaya bağlı komplikasyonların ve hastane yatış oranlarının azaltılabilmesi için küçük yaştaki çocuklar ile kronik hastalığı olan vakalar aşılanmalıdır

Anahtar Kelimeler

İnfluenza, çocuk, komplikasyon

Kaynakça

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