Roentgenographic features of common pediatric viral respiratory tract infections
S. R. Wildin, T. Chonmaitree and L. E. Swischuk
Department of Pediatrics, University of Texas Medical Branch, Galveston 77550.
Viral infections of the respiratory tract in infants and children are
common. Little has been reported on roentgenographic findings associated
with infection caused by common viruses other than with respiratory
syncytial virus. We studied chest roentgenograms from 128 previously
healthy infants and children who were infected with respiratory syncytial
virus, parainfluenza virus, influenza virus, or adenovirus. Four common
roentgenographic findings were detected: parahilar peribronchial
infiltrates, hyperexpansion, segmental or lobar atelectasis, and hilar
adenopathy. Diffuse interstitial infiltrates and significant pleural fluid
accumulations rarely occurred in our series. We confirmed the popular but
not well-documented belief that other common respiratory viruses can be
associated with roentgenographic findings similar to those caused by
respiratory syncytial virus. However, respiratory syncytial virus infection
is associated with more abnormal chest roentgenograms than any of the other
viruses regardless of the clinical syndrome. Hilar adenopathy was more
common in adenovirus infection. Young infants had significantly more
abnormal chest roentgenograms, with more hyperexpansion and parahilar
peribronchial infiltration than older children. We also found a significant
correlation between lobar atelectasis and severity of the illness. In
infants and children with viral infection of the lower respiratory tract,
roentgenographic information can be a useful adjunct to clinical viral
diagnosis.
