Chapter 2 : Respiratory Infections

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Respiratory Infections, Page 1 of 2

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This chapter describes the clinical syndromes of respiratory virus infection, the spectrum of viruses associated with these syndromes, and the pathophysiology of these illnesses. Many of the viruses associated with acute respiratory disease display a significant seasonal variation in incidence, especially in temperate climates. The majority of common colds are associated with infection with rhinoviruses or other picornaviruses, particularly when very sensitive techniques, such as polymerase chain reaction (PCR), are used for diagnosis. Viral pathogens associated with acute pharyngitis are summarized in this chapter. Pharyngitis is a typical component of acute influenza in which individuals experience the sudden onset of systemic symptoms of fever, myalgias, and malaise accompanied by upper respiratory signs and symptoms, including pharyngitis. The majority of cases of inspiratory stridor in children are caused by viral croup. In addition to causing croup and bronchiolitis, viral infection of the trachea and bronchi may cause tracheitis or tracheobronchitis. Antiviral therapy is available for some of the viruses responsible for bronchiolitis, but the use of such therapy for the most common etiology, respiratory syncytial virus (RSV), remains controversial. Viral pneumonia is an important cause of morbidity and mortality in individuals with compromised immune systems, with a broader spectrum of viral agents than seen in immunologically intact individuals. The general features of primary viral pneumonia are discussed using influenza as a model. Pathogenesis of other forms of viral pneumonia is also discussed.

Citation: Treanor J. 2009. Respiratory Infections, p 7-27. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch2

Key Concept Ranking

Upper Respiratory Tract Infections
Lower Respiratory Tract Infections
Severe Acute Respiratory Syndrome
Viral Lower Respiratory Tract Infections
Immune Systems
Respiratory Diseases
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Image of FIGURE 1

Many of the viruses which affect the respiratory tract exhibit a seasonal variation in prevalence. In this figure, numbers of virus isolates from children seen in private pediatric practices in Rochester, NY, are plotted by month of isolation. Data represent the 6-year average from 1990 to 1995 and are expressed as the percentage of all isolates of each virus which occurred in the given month.

Citation: Treanor J. 2009. Respiratory Infections, p 7-27. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch2
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Image of FIGURE 2

Posteroanterior roentgenogram of the neck of a child with viral croup that shows the characteristic narrowing of the air shadow of the trachea in the subglottic area. (Courtesy of Carolyn B. Hall, University of Rochester.)

Citation: Treanor J. 2009. Respiratory Infections, p 7-27. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch2
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Image of FIGURE 3

Lateral neck radiograph of the neck of a child with epiglottitis demonstrates the characteristic thickening of the epiglottis in this disease and may be helpful in distinguishing this illness from croup or retropharyngeal abscess. (Courtesy of Carolyn B. Hall, University of Rochester.)

Citation: Treanor J. 2009. Respiratory Infections, p 7-27. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch2
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Image of FIGURE 4

Pathophysiology of croup. Both mechanical obstruction of airflow and ventilation-perfusion mismatching due to parenchymal infection of the lung are responsible for the hypoxia and respiratory distress of croup. (Modified from reference with permission.)

Citation: Treanor J. 2009. Respiratory Infections, p 7-27. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch2
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Image of FIGURE 5

The chest radiograph in bronchiolitis characteristically shows hyperinflation due to obstruction of airflow. A variety of other findings may be present, including interstitial infiltrates or lobar consolidation. (Courtesy of Carolyn B. Hall, University of Rochester.)

Citation: Treanor J. 2009. Respiratory Infections, p 7-27. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch2
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Image of FIGURE 6

Pathophysiology of bronchiolitis. Viral infection of the lower respiratory tract results in inflammation and increased mucus production. Both airway obstruction and ventilation-perfusion mismatching are responsible for the clinical findings of hypoxia, hyperinflation, and hypoventilation. If uncorrected, these defects can lead to apnea or sudden death. FRC, functional residual capacity; RV, residual volume; A-P, anterior-posterior. (Modified from reference with permission.)

Citation: Treanor J. 2009. Respiratory Infections, p 7-27. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch2
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1. Aherne, W.,, T. Bird,, S. D. M. Court,, P. S. Gardner, and, J. McQuillin. 1970. Pathologic changes in virus infections of the lower respiratory tract in children. J. Clin. Pathol. 23:718.
2. Allander, T.,, T. Jartti,, S. Gupta,, H. G. M. Niesters,, P. Lehtinen,, R. Osterback,, T. Vuorinen,, M. Waris,, A. Bjerkner,, A. Tiveljung-Lindell,, B. G. van den Hoogen,, T. Hyypia, and, O. Ruuskanen. 2007. Human bocavirus and acute wheezing in children. Clin. Infect. Dis. 44:904910.
3. American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. 2006. Diagnosis and management of bronchiolitis. Pediatrics 118:17741793.
4. Anderson, L. J. 2007. Human bocavirus: a new viral pathogen. Clin. Infect. Dis. 44:911912.
5. Angeles-Marcos, M.,, M. Camps,, T. Pumarola,, J. Antonio-Martinez,, E. Martinez,, J. Mensa,, E. Garcia,, G. Penarroja,, P. Dambrava,, I. Casas,, M. T. Jimenez de Anta, and, A. Torres. 2006. The role of viruses in the aetiology of community-acquired pneumonia in adults. Antivir. Ther. 11:351359.
6. Arruda, E.,, T. R. Boyle,, B. Winther,, D. C. Pevear,, J. M. Gwaltney, Jr., and, F. G. Hayden. 1995. Localization of human rhinovirus replication in the upper respiratory tract by in situ hybridization. J. Infect. Dis. 171:13291333.
7. Arruda, E.,, A. Pitkaranta,, T. J. J. Witek,, C. A. Doyle, and, F. G. Hayden. 1997. Frequency and natural history of rhinovirus infections during autumn. J. Clin. Microbiol. 35:26842688.
8. Attia, M.,, T. Zaoutis,, S. Eppes,, J. O. Klein, and, F. Meier. 1999. Multivariate predictive models for group A beta-hemolytic streptococcal pharyngitis in children. Acad. Emerg. Med. 6:813.
9. Barnes, S. D.,, J. M. Leclair,, M. S. Forman,, T. R. Townsend,, G. M. Laughlin, and, P. Charache. 1989. Comparison of nasal brush and nasopharyngeal aspirate techniques in obtaining specimens for detection of respiratory syncytial viral antigen by immunofluorescence. Pediatr. Infect. Dis. J. 8:598601.
10. Becroft, D. M. O. 1971. Brochiolitis obliterans, bronchiolitis, and other sequelae of adenovirus type 21 infection in young children. J. Clin. Pathol. 24:7281.
11. Berman, S. 1991. Epidemiology of acute respiratory infections in children of developing countries. Rev. Infect. Dis. 13:S454S462.
12. Bjornson, C. L.,, T. P. Klassen,, J. Williamson,, R. Brant,, C. Mitton,, A. Plint,, B. Bulloch,, L. Evered, and, D. W. Johnson. 2004. A randomized trial of a single dose of oral dexamethasone for mild croup. N. Engl. J. Med. 351:13061313.
13. Booth, C. M.,, L. M. Matukas,, G. A. Tomlinson,, A. R. Rachlis,, D. B. Rose,, H. A. Dwosh,, S. L. Walmsley,, T. Mazzulli,, M. Avendano,, P. Derkach,, I. E. Ephtimios,, I. Kitai,, B. D. Mederski,, S. B. Shadowitz,, W. L. Gold,, L. A. Hawryluck,, E. Rea,, J. S. Chenkin,, D. W. Cescon,, S. M. Poutanen, and, A. S. Detsky. 2003. Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. JAMA 289:28012809.
14. Bowden, R. A. 1997. Respiratory virus infections after marrow transplant: the Fred Hutchinson Cancer Research Center experience. Am. J. Med. 102(3A):2730.
15. Bright, R. A.,, D. K. Shay,, B. Shu,, N. J. Cox, and, A. I. Klimov. 2006. Adamantane resistance among influenza A viruses isolated early during the 2005–2006 influenza season in the United States. JAMA 295:891894.
16. Buchman, C. A.,, W. J. Doyle,, D. P. Skoner,, J. C. Post,, C. M. Alper,, J. T. Seroky,, K. Anderson,, R. A. Preston,, F. G. Hayden,, P. Fireman, and, G. D. Ehrlich. 1995. Influenza A virus-induced acute otitis media. J. Infect. Dis. 172:13481351.
17. Butler, J. C.,, and C. J. Peters. 1994. Hantaviruses and hantavirus pulmonary syndrome. Clin. Infect. Dis. 19:387395.
18. Chapman, L. E.,, G. J. Mertz,, C. J. Peters,, H. M. Jolson,, A. S. Khan,, T. G. Ksiazek,, F. T. Koster,, K. F. Baum,, P. E. Rollin,, A. T. Pavia,, R. C. Holman,, J. C. Christenson,, P. J. Rubin,, R. E. Behrman,, L. J. Bell,, G. L. Simpson, and, R. F. Sadek for the Ribavirin Study Group. 1999. Intravenous ribavirin for hantavirus pulmonary syndrome: safety and tolerance during 1 year of open-label experience. Antivir. Res. 4:211219.
19. Cherry, J. D. 2008. Croup. N. Engl. J. Med. 358:384391.
20. Chidekel, A. S.,, A. R. Bazzy, and, C. L. Rosen. 1994. Rhinovirus infection associated with severe lower respiratory tract illness and worsening lung disease in infants with bronchopulmonary dysplasia. Pediatr. Pulmonol. 18:261263.
21. Corneli, H. M.,, J. J. Zorc,, P. Mahajan,, K. N. Shaw,, R. Holubkov,, S. D. Reeves,, R. M. Ruddy,, B. Malik,, K. A. Nelson,, J. S. Bregstein,, K. M. Brown,, M. N. Denenberg,, K. A. Lillis,, L. B. Cimpello,, J. W. Tsung,, D. A. Borgialli,, M. N. Baskin,, G. Teshome,, M. A. Goldstein,, D. Monroe,, J. M. Dean,, N. Kuppermann, and the Bronchiolitis Study Group of the Pediatric Emergency Care Applied Research Network (PECARN). 2007. A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis. N. Engl. J. Med. 357:331339.
22. Cui, W.,, Y. Fan,, W. Wu,, F. Zhang,, J. Y. Wang, and, A. P. Ni. 2003. Expression of lymphocytes and lymphocyte subsets in patients with severe acute respiratory syndrome. Clin. Infect. Dis. 37:857859.
23. Dawson, K. P.,, A. Long,, J. Kennedy, and, N. Mogridge. 1990. The chest radiograph in acute bronchiolitis. J. Paediatr. Child Health 26:209211.
24. Del Mar, C. B.,, P. P. Glasziou, and, A. B. Spinks. 2000. Antibiotics for sore throat. Cochrane Database of Systemic Reviews CD000023.
25. Denny, F. W.,, T. F. Murphy,, W. A. J. Clyde,, A. M. Collier, and, F. W. Henderson. 1983. Croup: an 11-year study in a pediatric practice. Pediatrics 71:871876.
26. Department of Health and Human Services. 1994. Current estimates from the National Health Interview survey, 1992. DHHS publication no. (PHS) 94-1517. Department of Health and Human Services, Hyattsville, MD.
27. Diamond, L.,, R. J. Dockhorn,, J. Grossman,, J. C. Kisicki,, M. Posner,, M. A. Zinny,, P. Koker,, D. Korts, and, M. T. Wecker. 1995. A dose-response study of the efficacy and safety of ipratropium bromide nasal spray in the treatment of the common cold. J. Allergy Clin. Immunol. 95:11391146.
28. Dingle, J. H.,, G. F. Badger, and, W. S. Jordan, Jr. 1964. Illness in the home: study of 25,000 illnesses in a group of Cleveland families. Press of Case Western University, Cleveland, OH.
29. Doyle, W. J.,, D. K. Riker,, T. P. McBride,, F. G. Hayden,, J. O. Hendley,, J. D. Swarts, and, J. M. Gwaltney, Jr. 1993. Therapeutic effects of an anticholinergicsympathomimetic combination in induced rhinovirus colds. Ann. Otol. Rhinol. Laryngol. 102:521527.
30. Duchin, J. S.,, F. T. Koster,, C. J. Peters,, G. L. Simpson,, B. Tempest,, S. R. Zaki,, T. G. Ksiazer,, P. E. Rollin,, S. Nichohl,, E. T. Umland,, R. L. Moolenaar,, S. E. Reef,, K. B. Nolte,, M. M. Gallaher,, J. C. Butler, and, R. F. Breiman. 1994. Hantavirus pulmonary syndrome: a clinical description of 17 patients with a newly recognized disease. N. Engl. J. Med. 330:949955.
31. Dykewicz, C. 2001. Summary of the guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Clin. Infect. Dis. 33:139144.
32. Elkhatieb, A.,, G. Hipskind,, D. Woerner, and, F. G. Hayden. 1993. Middle ear abnormalities during natural rhinovirus colds in adults. J. Infect. Dis. 168:618621.
33. Emanuel, D.,, I. Cunningham,, K. Jules-Elysee,, J. A. Brochstein,, N. A. Kernan,, J. Laver,, D. Stover,, D. A. White,, A. Fels,, B. Polsky,, H. Castro-Malaspina,, J. R. Peppard,, B. P. U. Hammerling, and, R. J. O’Reilly. 1988. Cytomegalovirus pneumonia after bone marrow transplantation successfully treated with the combination of ganciclovir and high-dose intravenous immune globulin. Ann. Intern. Med. 109:777782.
34. Englund, J. A.,, C. J. Sullivan, and, M. C. Jordan. 1988. Respiratory syncytial virus infection in immunocompromised adults. Ann. Intern. Med. 109:203208.
35. Enright, H.,, R. Haake,, D. Weisdorf,, N. Ramsay,, P. McGlave,, J. Kersey,, W. Thomas,, D. McKenzie, and, W. Miller. 1993. Cytomegalovirus pneumonia after bone marrow transplantation: risk factors and response to therapy. Transplantation 55:13391346.
36. Esper, F.,, C. Weibel,, D. Ferguson,, M. L. Landry, and, J. S. Kahn. 2005. Evidence of a novel human coronavirus that is associated with respiratory tract disease in infants and young children. J. Infect. Dis. 191:492498.
37. Falsey, A.,, and E. E. Walsh. 2006. Viral pneumonia in older adults. Clin. Infect. Dis. 42:518524.
38. Falsey, A. R. 1998. Respiratory syncytial virus infection in older persons. Vaccine 16:17751778.
39. Falsey, A. R.,, R. M. McCann,, W. J. Hall,, M. M. Criddle,, M. A. Formica,, D. Wycoff, and, J. E. Kolassa. 1997. The “common cold” in frail older persons: impact of rhinovirus and coronavirus in a senior daycare center. J. Am. Geriatr. Soc. 45:706711.
40. Forni, A. L.,, N. W. Schluger, and, R. B. Roberts. 1994. Severe measles pneumonitis in adults: evaluation of clinical characteristics and therapy with intravenous ribavirin. Clin. Infect. Dis. 19:454462.
41. Foy, H. M.,, M. K. Cooney,, A. J. Maletzky, and, J. T. Grayston. 1973. Incidence and etiology of pneumonia, croup, and bronchiolitis in preschool children belonging to a prepaid medical care group over a four-year period. Am. J. Epidemiol. 97:8092.
42. Friedlander, S. L.,, and W. W. Busse. 2005. The role of rhinovirus in asthma exacerbations. J. Allergy Clin. Immunol. 116:267273.
43. Friis, B.,, M. Eiken,, A. Hornsleth, and, A. Jensen. 1990. Chest X-ray appearances in pneumonia and bronchiolitis. Correlation to virological diagnosis and secretory bacterial findings. Acta Paediatr. Scand. 79:219225.
44. Fulginiti, V. A.,, J. J. Eller,, O. F. Sieber,, J. W. Joyner,, M. Minamitani, and, G. Meiklejohn. 1969. Respiratory virus immunization. I. A field trial of two inactivated respiratory virus vaccines: an aqueous trivalent parainfluenza virus vaccine and an alum-precipitated respiratory syncytial virus vaccine. Am. J. Epidemiol. 89:435448.
45. Gelfand, E. W.,, D. McCurdy, and, D. P. Rao. 1983. Ribavirin treatment of viral pneumonitis in severe combined immunodeficiency disease. Lancet ii:732783.
46. Gerber, M. A.,, R. R. Tanz,, W. Kabat,, E. Dennis,, G. L. Bell,, E. L. Kaplan, and, S. T. Shulman. 1997. Optical immunoassay for group A beta-hemolytic streptococcal pharyngitis. An office-based, multicenter investigation. JAMA 277:899903.
47. Ghosh, S.,, R. E. Champlin,, J. Englund,, S. A. Giralt,, K. Rolston,, I. Raad,, K. Jacobson,, J. Neumann,, C. Ippoliti,, S. Mallik, and, E. Whimbey. 2000. Respiratory syncytial virus upper respiratory tract illnesses in adult blood and marrow transplant recipients: combination therapy with aerosolized ribavirin and intravenous immunoglobulin. Bone Marrow Transplant. 25:751755.
48. Glezen, W. P.,, L. H. Taber,, A. L. Frank, and, J. A. Kasel. 1986. Risk of primary infection and reinfection with respiratory syncytial virus. Am. J. Dis. Child. 140:543546.
49. Gonzales, R.,, and M. A. Sande. 2000. Uncomplicated acute bronchitis. Ann. Intern. Med. 133:981991.
50. Gozal, D.,, A. A. Colin,, M. Jaffe, and, Z. Hochberg. 1990. Water, electrolyte, and endocrine homeostasis in infants with bronchiolitis. Pediatr. Res. 27:204209.
51. Greenberg, D.,, R. Walker,, M. S. Lee,, K. Reisinger,, J. Ward,, R. Yogev,, M. Blatter,, S. Yeh,, R. Karron,, C. Sangli,, L. Eubank,, K. Coelingh,, J. Cordova,, M. August, and, H. Mehta. 2005. A bovine parainfluenza virus type 3 vaccine is safe and immunogenic in early infancy. J. Infect. Dis. 191:11161122.
52. Grinblat, L.,, H. Shulman,, A. Glickman,, L. Matukas, and, N. Paul. 2003. Severe acute respiratory syndrome: radiographic review of 40 probable cases in Toronto, Canada. Radiology 228:802809.
53. Grundy, J. E. 1990. Virologic and pathogenetic aspects of cytomegalovirus infection. Rev. Infect. Dis. 12:S711S719.
54. Gubareva, L. V.,, L. Kaiser, and, F. G. Hayden. 2000. Influenza virus neuraminidase inhibitors. Lancet 355:827835.
55. Guerguerian, A. M.,, M. Gauthier,, M. H. Lebel,, C. A. Farrell, and, J. Lacroix. 1999. Ribavirin in ventilated respiratory syncytial virus bronchiolitis. A randomized, placebo-controlled trial. Am. J. Resp. Crit. Care Med. 160:829834.
56. Gwaltney, J. M.,, Jr., J. O. Hendley,, G. Simon, and, W. S. Jordan, Jr. 1966. Rhinovirus infections in an industrial population. I. The occurrence of illness. N. Engl. J. Med. 275:12611268.
57. Gwaltney, J. M.,, Jr., C. D. Phillips,, R. D. Miller, and, D. K. Riker. 1994. Computed tomographic study of the common cold. N. Engl. J. Med. 330:2530.
58. Gwaltney, J. M.,, Jr., and H. M. Druce. 1997. Efficacy of brompheniramine maleate for the treatment of rhinovirus colds. Clin. Infect. Dis. 25:11881194.
59. Haake, D. A.,, P. C. Zakowski,, D. L. Haake, and, Y. J. Bryson. 1990. Early treatment with acyclovir for varicella pneumonia in otherwise healthy adults: retrospective controlled study and review. Rev. Infect. Dis. 12:788798.
60. Hall, C. B. 1995. Acute laryngotracheobronchitis (croup), p. 573–579. In G. L. Mandell,, J. E. Bennett, and, R. Dolin (ed.), Principles and Practice of Infectious Diseases, 4th ed. Churchill Livingstone, New York, NY.
61. Hall, C. B.,, J. M. Geiman,, B. B. Breese, and, R. G. Douglas, Jr. 1977. Parainfluenza viral infections in children: correlation of shedding with clinical manifestations. J. Pediatr. 91:194198.
62. Hall, C. B.,, W. J. Hall, and, D. M. Speers. 1979. Clinical and physiological manifestations of bronchiolitis and pneumonia: outcome of respiratory syncytial virus. Am. J. Dis. Child. 133:798802.
63. Hall, C. B.,, and J. T. McBride. 2000. Acute laryngotracheobronchitis, p. 663–669. In G. L. Mandell,, J. E. Bennett, and, R. Dolin (ed.), Principles and Practice of Infectious Diseases, 5th ed. Churchill Livingstone, Philadelphia, PA.
64. Hall, C. B.,, K. R. Powell,, N. E. MacDonald,, C. L. Gala,, M. E. Menegus,, S. C. Suffin, and, H. J. Cohen. 1986. Respiratory syncytial viral infection in children with compromised immune function. N. Engl. J. Med. 315:7781.
65. Hall, W. J.,, C. B. Hall, and, D. M. Speers. 1978. Respiratory syncytial virus infection in adults: clinical, virologic, and serial pulmonary function studies. Ann. Intern. Med. 88:203205.
66. Han, L. L.,, J. P. Alexander, and, L. J. Anderson. 1999. Respiratory syncytial virus pneumonia among the elderly: an assessment of disease burden. J. Infect. Dis. 179:2530.
67. Hayden, F.,, D. Herrington,, T. Coats,, K. Kim,, E. Cooper,, S. Villano,, S. Liu,, S. Hudson,, D. Pevear,, M. Collett, and, M. McKinlay. 2003. Efficacy and safety of oral pleconaril for treatment of colds due to picornaviruses in adults: results of 2 double-blind, randomized, placebo-controlled trials. Clin. Infect. Dis. 36:15231532.
68. Henderson, F. W.,, W. A. Clyde, Jr.,, A. M. Collier,, F. W. Denny,, R. J. Senior,, C. I. Sheaffer,, W. G. Conley, and, R. M. Christian. 1979. The etiologic and epidemiologic spectrum of bronchiolitis in pediatric practice. J. Pediatr. 95:183190.
69. Henderson, F. W.,, A. M. Collier,, M. A. Sanyal,, J. M. Watkins,, D. L. Fairclough,, W. A. Clyde, Jr., and, F. W. Denny. 1982. A longitudinal study of respiratory viruses and bacteria in the etiology of acute otitis media with effusion. N. Engl. J. Med. 306:13771383.
70. Hertz, M. I.,, J. A. Englund,, D. Snover,, P. B. Bitterman, and, P. B. McGlave. 1989. Respiratory syncytial virus-induced acute lung injury in adult patients with bone marrow transplants: a clinical approach and review of the literature. Medicine 68:269281.
71. Hierholzer, J. C.,, R. Wigand,, L. J. Anderson,, T. Adrian, and, J. W. M. Gold. 1988. Adenoviruses from patients with AIDS: a plethora of serotypes and a description of five new serotypes of subgenus D (types 43–47). J. Infect. Dis. 158:804813.
72. Huovinen, P.,, R. Lahtonen,, T. Ziegler,, O. Meurman,, K. Hakkarainen,, A. Miettinen,, P. Arstila,, J. Eskola, and, P. Saikku. 1989. Pharyngitis in adults: the presence and coexistence of viruses and bacterial organisms. Ann. Intern. Med. 110:612616.
73. Hyypia, T.,, T. Puhakka,, O. Ruuskanen,, M. Makela,, A. Arola, and, P. Arstila. 1998. Molecular diagnosis of human rhinovirus infection: comparison with virus isolation. J. Clin. Microbiol. 36:20812083.
74. Igarashi, Y.,, D. P. Skoner,, W. J. Doyle,, M. V. White,, P. Fireman, and, M. A. Kaliner. 1993. Analysis of nasal secretions during experimental rhinovirus upper respiratory infections. J. Allergy Clin. Immunol. 92:722731.
75. Impact-RSV Study Group. 1998. Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. Pediatrics 102:531537.
76. Ison, M. G.,, and J. A. Fishman. 2005. Cytomegalovirus pneumonia in transplant recipients. Clin. Chest Med. 26:691705.
77. Jawad, S. S.,, and R. Eccles. 1998. Effect of pseudoephedrine on nasal airflow in patients with nasal congestion associated with common cold. Rhinology 36:7376.
78. Johnson, D. W.,, S. Jacobson,, P. C. Edney,, P. Hadfield,, M. E. Mundy, and, S. Schuh. 1998. A comparison of nebulized budesonide, intramuscular dexamethasone, and placebo for moderately severe croup. N. Engl. J. Med. 339:498503.
79. Kaplan, L. J.,, R. S. Daum,, M. Smaron, and, C. A. McCarthy. 1992. Severe measles in immunocompromised patients. JAMA 267:12371241.
80. Khamapirad, T.,, and W. P. Gelzen. 1987. Clinical and radiographic assessment of acute lower respiratory tract disease in infants and children. Semin. Respir. Infect. 2:130144.
81. Kim, H. W.,, J. O. Arrobio,, C. D. Brandt,, B. C. Jeffries,, G. Pyles,, J. L. Reid,, R. M. Chanock, and, R. H. Parrott. 1973. Epidemiology of respiratory syncytial virus infection in Washington, D.C. I. Importance of the virus in different respiratory tract disease syndromes and temporal distribution of infection. Am. J. Epidemiol. 98:216225.
82. Kim, H. W.,, C. D. Brandt,, J. O. Arrobio,, B. Murphy,, R. M. Chanock, and, R. H. Parrott. 1979. Influenza A and B virus infection in infants and young children during the years 1957–1976. Am. J. Epidemiol. 109:464479.
83. Klassen, T. P.,, M. E. Feldman,, L. K. Watters,, T. Sutcliffe, and, P. C. Rowe. 1994. Nebulized budesonide for children with mild-to-moderate croup. N. Engl. J. Med. 331:285289.
84. Klinger, J. R.,, M. P. Sanchez,, L. A. Curtin,, M. Durkin, and, B. Matyas. 1998. Multiple cases of life-threatening adenovirus pneumonia in a mental health care center. Am. J. Respir. Crit. Care Med. 157:645649.
85. Lambert, S. B.,, K. M. Allen,, J. D. Druce,, C. J. Birch,, I. M. Mackay,, J. B. Carlin,, J. R. Carapetis,, T. P. Sloots,, M. D. Nissen, and, T. M. Nolan. 2007. Community epidemiology of human metapneumovirus, human corona-virus NL63, and other respiratory viruses in healthy preschool-aged children using parent-collected specimens. Pediatrics 120:e929e937.
86. Lang, S. A.,, P. G. Duncan,, D. A. Shephard, and, H. C. Ha. 1990. Pulmonary edema associated with airway obstruction. Can. J. Anesth. 37:210218.
87. La Rosa, A. M.,, R. E. Champlin,, N. B. Mirza,, J. Gajewski,, S. Giralt,, K. V. Rolston,, I. Raad,, K. Jacobson,, D. Kontoyiannis,, L. Elting, and, E. Whimbey. 2001. Adenovirus infections in adult recipients of blood and marrow transplants. Clin. Infect. Dis. 32:871875.
88. Lau, S. K. P.,, C. C. Y. Yip,, H.-W. Tsoi,, R. A. Lee,, L.-Y. So,, Y.-L. Lau,, K.-H. Chan,, P. C. Y. Woo, and, K.-Y. Yuen. 2007. Clinical features and complete genome characterization of a distinct human rhinovirus (HRV) genetic cluster, probably representing a previously undetected HRV species, HRV-C, associated with acute respiratory illness in children. J. Clin. Microbiol. 45:36553664.
89. Lebel, M. H.,, M. Gauthier,, J. Lacroix,, E. Rousseau, and, M. Buithieu. 1989. Respiratory failure and mechanical ventilation in severe bronchiolitis. Arch. Dis. Child. 64:14311437.
90. Lee, N.,, D. Hui,, A. Wu,, P. Chan,, P. Cameron,, G. M. Joynt,, A. Ahuja,, M. Y. Yung,, C. B. Leung,, K. F. To,, S. F. Lui,, C. C. Szeto,, S. Chung, and, J. J. Sung. 2003. A major outbreak of severe acute respiratory syndrome in Hong Kong. N. Engl. J. Med. 348:19861994.
91. Lesouef, P. N.,, G. C. Geelhoed,, D. J. Turner,, S. E. Morgan, and, L. I. Landau. 1989. Response of normal infants to inhaled histamine. Am. Rev. Respir. Dis. 139:6266.
92. Levandowski, R. A.,, T. R. Gerrity, and, C. S. Garrard. 1985. Modifications of lung clearance mechanisms by acute influenza A infection. J. Lab. Clin. Med. 106:428432.
93. Louie, J.,, A. Kajon,, M. Holodniy,, L. Guardia-LaBar,, B. Lee,, A. Petru,, J. Hacker, and, D. Schnurr. 2008. Severe pneumonia due to adenovirus serotype 14: a new respiratory threat? Clin. Infect. Dis. 46:421425.
94. Louria, D. B.,, H. L. Blumenfeld,, J. T. Ellis,, E. D. Kilbourne, and, D. E. Rogers. 1959. Studies on influenza in the pandemic of 1957–1958. II. Pulmonary complications of influenza. J. Clin. Investig. 38:213265.
95. Mallia, P.,, and S. L. Johnston. 2006. How viral infections cause exacerbation of airway diseases. Chest 130:12031210.
96. Markowitz, L. E.,, and P. Neiburg. 1991. The burden of acute respiratory infection due to measles in developing countries and the potential impact of measles vaccine. Rev. Infect. Dis. 13:S555S561.
97. Marx, A.,, H. E. Gary, Jr.,, B. J. Marston,, D. D. Erdman,, R. F. Breiman,, T. J. Torok,, J. F. Plouffe,, T. M. File, Jr., and, L. J. Anderson. 1999. Parainfluenza virus infection among adults hospitalized for lower respiratory tract infection. Clin. Infect. Dis. 29:134140.
98. Mayo-Smith, M. F.,, J. W. Spinale,, C. J. Donskey,, M. Yukawa,, R. H. Li, and, F. J. Schiffman. 1995. Acute epiglottitis: an 18-year experience in Rhode Island. Chest 108:16401647.
99. McIsaac, W. J.,, J. D. Kellner,, P. Aufricht,, A. Vanjaka, and, D. E. Low. 2004. Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA 291:15871595. (Erratum, 294:2700, 2005.)
100. McMillan, J. A.,, L. B. Weiner,, A. M. Higgins, and, K. MacKnight. 1993. Rhinovirus infection associated with serious illness among pediatric patients. Pediatr. Infect. Dis. J. 12:321325.
101. Meert, K. L.,, A. P. Sarnaik,, M. J. Gelmini, and, M. W. Lich-Lai. 1994. Aerosolized ribavirin in mechanically ventilated children with respiratory syncytial virus lower respiratory tract disease: a prospective, double-blind, randomized trial. Crit. Care Med. 22:566572.
102. Mohsen, A. H.,, and M. McKendrick. 2003. Varicella pneumonia in adults. Eur. Respir. J. 21:886891.
103. Monto, A. S.,, and K. M. Sullivan. 1993. Acute respiratory illness in the community: frequency of illness and the agents involved. Epidemiol. Infect. 110:145160.
104. Mosser, A. G.,, R. Vrtis,, L. Burchell,, W. M. Lee,, C. R. Dick,, E. Weisshaar,, D. Bock,, C. A. Swenson,, R. D. Cornwell,, K. C. Meyer,, N. N. Jarjour,, W. W. Busse, and, J. E. Gern. 2005. Quantitative and qualitative analysis of rhinovirus infection in bronchial tissues. Am. J. Respir. Crit. Care Med. 171:645651.
105. Müller, N. L.,, G. C. Ooi,, P. L. Khong, and, S. Nicolaou. 2003. Severe acute respiratory syndrome: radiographic and CT findings. Am. J. Roentgenol. 181:38.
106. Naclerio, R. M.,, D. Proud,, A. Kagey-Sobotka,, L. M. Lichtenstein,, J. O. Hendley, and, J. M. Gwaltney, Jr. 1988. Kinins are generated during experimental rhinovirus colds. J. Infect. Dis. 157:133142.
107. Neuzil, K. M.,, G. W. Reed,, E. F. Mitchel,, L. Simonsen, and, M. R. Griffin. 1998. The impact of influenza on acute cardiopulmonary hospitalizations in pregnant women. Am. J. Epidemiol. 148:10941102.
108. Okamoto, Y.,, K. Kudo,, K. Ishikawa,, E. Ito,, K. Togawa,, I. Saito,, I. Moro,, J. A. Patel, and, P. L. Ogra. 1993. Presence of respiratory syncytial virus genomic sequences in middle ear fluid and its relationship to expression of cytokines and cell adhesion molecules. J. Infect. Dis. 168:12771281.
109. Pahl, E.,, and S. S. Gidding. 1988. Echocardiographic assessment of cardiac function during respiratory syncytial virus infection. Pediatrics 81:830834.
110. Parrott, R. H.,, H. W. Kim, and, J. O. Arrobio. 1973. Epidemiology of respiratory syncytial virus infection in Washington, D.C. Am. J. Epidemiol. 98:289300.
111. Paul, I. M.,, J. Beiler,, A. McMonagle,, M. L. Shaffer,, L. Duda, and, C. M. Berlin, Jr. 2007. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch. Pediatr. Adolesc. Med. 161:11401146.
112. Peiris, J. S.,, S. T. Lai,, L. L. M. Poon,, Y. Guan,, L. Y. C. Yam,, W. Lim,, J. Nicholls,, W. K. S. Yee,, W. W. Yan,, M. T. Cheung,, V. C. C. Cheng,, K. H. Chan,, D. N. C. Tsang,, R. W. H. Yung,, T. K. Ng,, K. Y. Yuen, and Members of the SARS Study Group. 2003. Coronavirus as a possible cause of severe acute respiratory syndrome. Lancet 361:13191325.
113. Pitkaranta, A.,, A. Virolainen,, J. Jero,, E. Arruda, and, F. G. Hayden. 1998. Detection of rhinovirus, respiratory syncytial virus, and coronavirus infections in acute otitis media by reverse transcriptase polymerase chain reaction. Pediatrics 102:291295.
114. Proud, D.,, C. J. Reynolds,, S. Lacapra,, A. Kagey-Sobotka,, L. M. Lichtenstein, and, R. M. Naclerio. 1988. Nasal provocation with bradykinin induces symptoms of rhinitis and sore throat. Am. Rev. Respir. Dis. 137:613616.
115. Ramsey, P. G.,, K. H. Fife,, R. C. Hackman,, J. D. Meyers, and, L. Corey. 1982. Herpes simplex virus pneumonia: clinical, virologic, and pathologic features in 20 patients. Ann. Intern. Med. 97:813820.
116. Reed, E. C.,, R. A. Bowden,, P. S. Dandliker,, C. A. Gleaves, and, J. D. Meyers. 1986. Treatment of cytomegalovirus pneumonia with 9-[2-hydroxy-1-(hydroxymethyl) ethoxymethyl] guanine and high-dose corticosteroids. Ann. Intern. Med. 105:214215.
117. Reed, E. C.,, R. A. Bowden,, P. S. Dandliker,, K. E. Lilleby, and, J. D. Meyers. 1988. Treatment of cytomegalovirus pneumonia with ganciclovir and intravenous cytomegalovirus immunoglobulin in patients with bone marrow transplants. Ann. Intern. Med. 109:783788.
118. Rees, G. L.,, and R. Eccles. 1994. Sore throat following nasal and orophayrngeal bradykinin challenge. Acta Oto-Laryngol. 114:311314.
119. Ross, L. A.,, W. H. Mason,, J. Lanson,, T. W. Deakers, and, C. J. L. Newth. 1992. Laryngotracheobronchitis as a complication of measles during an urban epidemic. J. Pediatr. 121:511515.
120. Sable, C. A.,, and F. G. Hayden. 1995. Orthomyxoviral and paramyxoviral infections in transplant patients. Infect. Dis. Clin. N. Am. 9:9871003.
121. Schwarzmann, S. W.,, J. L. Adler,, R. F. J. Sullivan, and, W. M. Marine. 1971. Bacterial pneumonia during the Hong Kong influenza epidemic of 1968–1969. Arch. Intern. Med. 127:10371041.
122. Sharfstein, J. M.,, M. North, and, J. R. Serwint. 2007. Over the counter but no longer under the radar—pediatric cough and cold medications. N. Engl. J. Med. 357:23212324.
123. Sherry, M. K.,, A. S. Klainer,, M. Wolff, and, H. Gerhard. 1988. Herpetic tracheobronchitis. Ann. Intern. Med. 109:229233.
124. Slapak, I.,, J. Skoupa,, P. Strnad, and, P. Hornik. 2008. Efficacy of isotonic nasal wash (seawater) in the treatment and prevention of rhinitis in children. Arch. Otolaryngol. Head Neck Surg. 134:6774.
125. Sperber, S. J.,, J. O. Hendley,, F. G. Hayden,, D. K. Riker,, J. V. Sorrentino, and, J. M. Gwaltney, Jr. 1992. Effects of naproxen on experimental rhinovirus colds. A randomized, double-blind, controlled trial. Ann. Intern. Med. 117:3741.
126. Steensel-Moll, H. A.,, J. A. Hazelzet,, E. V. D. Voort,, H. J. Neijens, and, W. H. L. Hackeng. 1990. Excessive secretion of antidiuretic hormone in infections with respiratory syncytial virus. Arch. Dis. Child. 65:12371239.
127. Stein, R. T.,, D. Sherrill,, W. J. Morgan,, C. J. Holberg,, M. Halonen,, L. M. Taussig,, A. L. Wright, and, F. D. Martinez. 1999. Respiratory syncytial virus in early life and risk of wheeze and allergy by age 13 years. Lancet 354:541545.
128. Taverner, D.,, C. Danz, and, D. Econimos. 1999. The effects of oral pseudoephedrine on nasal patency in the common cold: a double-blind single-dose placebo-controlled trial. Clin. Otolaryngol. Allied Sci. 24:4751.
129. Turner, B. W.,, W. S. Cail,, J. O. Hendley,, F. G. Hayden,, W. J. Doyle,, J. V. Sorrention, and, J. M. Gwaltney, Jr. 1992. Physiologic abnormalities in the paranasal sinuses during experimental rhinovirus colds. J. Allergy Clin. Immunol. 90:474478.
130. Turner, R. B.,, S. J. Sperber,, J. V. Sorrentino,, R. R. O’Connor,, J. Rogers,, A. R. Batouli, and, J. M. Gwaltney, Jr. 1997. Effectiveness of clemastine fumarate for treatment of rhinorrhea and sneezing associated with the common cold. Clin. Infect. Dis. 25:824830.
131. Turner, R. B.,, M. T. Wecker,, G. Pohl,, T. J. Witek,, E. McNally,, R. St. George,, B. Winther, and, F. G. Hayden. 1999. Efficacy of tremacamra, a soluble intercellular adhesion molecule 1, for experimental rhinovirus infection: a randomized clinical trial. JAMA 281:17971804.
132. van den Hoogen, B. G.,, J. C. de Jong,, J. Groen,, T. Kuiken,, R. de Groot,, R. A. Fouchier, and, A. D. Osterhaus. 2001. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat. Med. 7:719724.
133. van Schaik, S. M.,, R. C. Welliver, and, J. L. L. Kimpen. 2000. Novel pathways in the pathogenesis of respiratory syncytial virus disease. Pediatr. Pulmonol. 30:131138.
134. Wainwright, C.,, L. Altamirano,, M. Cheney,, J. Cheney,, S. Barber,, D. Price,, S. Moloney,, A. Kimberley,, N. Woolfield,, S. Cadzow,, F. Fiumara,, P. Wilson,, S. Mego,, D. Vande-Velde,, S. Sanders,, P. O’Rourke, and, P. Francis. 2003. A multicenter, randomized, double-blind, controlled trial of nebulized epinephrine in infants with acute bronchiolitis. N. Engl. J. Med. 349:2735.
135. Waner, J. L.,, N. J. Whitehurst,, S. J. Todd,, H. Shalaby, and, L. V. Wall. 1990. Comparison of Directigen RSV with viral isolation and direct immunofluorescence for the identification of respiratory syncytial virus. J. Clin. Microbiol. 28:480483.
136. Wenzel, R. P.,, and A. A. Fowler. 2006. Acute bronchitis. N. Engl. J. Med. 355:21252130.
137. Whimbey, E.,, L. S. Eling,, R. B. Couch,, W. Lo,, L. Williams,, R. E. Champlin, and, G. P. Bodey. 1994. Influenza A virus infection among hospitalized adult bone marrow transplant recipients. Bone Marrow Transplant. 13:437440.
138. Wildin, S. R.,, T. Chonmaitree, and, L. E. Swischuk. 1988. Roentgenographic features of common pediatric viral respiratory tract infections. Am. J. Dis. Child. 142:4346.
139. Wilkinson, T. M.,, J. R. Hurst,, W. R. Perera,, M. Wilks,, G. C. Donaldson, and, J. A. Wedzicha. 2006. Effect of interactions between lower airway bacterial and rhinoviral infection in exacerbations of COPD. Chest 129:317324.
140. Williams, J. V.,, P. A. Harris,, S. J. Tollefson,, L. L. Halburnt-Rush,, J. M. Pingsterhaus,, K. M. Edwards,, P. F. Wright, and, J. E. Crowe, Jr. 2004. Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N. Engl. J. Med. 350:443450.
141. Wohl, M. E. B.,, and V. Chernick. 1978. Bronchiolitis. Am. Rev. Respir. Dis. 118:759781.
142. Wright, A. L.,, L. M. Taussig,, C. G. Ray,, H. R. Harrison, and, C. J. Holberg. 1989. The Tucson Children’s Respiratory Study. II. Lower respiratory tract illness in the first year of life. Am. J. Epidemiol. 129:12321246.
143. Wright, P. F.,, R. A. Karron,, R. B. Belshe,, J. Thompson,, J. E. J. Crowe,, T. G. Boyce,, L. L. Halburnt,, G. W. Reed,, S. S. Whitehead,, E. L. Anderson,, A. E. Wittek,, R. C. Casey,, M. Eichelberger,, B. Thumar,, V. B. Randolph,, S. A. Udem,, R. M. Chanock, and, B. R. Murphy. 2000. Evaluation of a live, cold-passaged, temperature-sensitive, respiratory syncytial virus vaccine candidate in infancy. J. Infect. Dis. 182:13311342.
144. Yelandi, A. V.,, and T. V. Colby. 1994. Pathologic features of lung biopsy specimens from influenza pneumonia cases. Hum. Pathol. 25:4753.
145. Yoon, B. W.,, H. J. Bae,, K. S. Hong,, S. M. Lee,, B. J. Park,, K. H. Yu,, M. K. Han,, Y. S. Lee,, D. K. Chung,, J. M. Park,, S. W. Jeong,, B. C. Lee,, K. H. Cho,, J. S. Kim,, S. H. Lee,, K. M. Yoo, and Acute Brain Bleeding Analysis (ABBA) Study Investigators. 2007. Phenylpropanolamine contained in cold remedies and risk of hemorrhagic stroke. Neurology 68:146149.
146. Zaki, S. R.,, P. W. Greer,, L. M. Coffield,, C. S. Goldsmith,, K. B. Nolte,, K. Foucar,, R. M. Feddersen,, R. E. Zumwalt,, G. L. Miller,, A. S. Khan,, P. E. Rollin,, T. G. Ksiazek,, S. T. Nichol,, B. W. J. Mahy, and, C. J. Peters. 1995. Hantavirus pulmonary syndrome: pathogenesis of an emerging infectious disease. Am. J. Pathol. 146:552579.
147. Zaroukian, M. H.,, and I. Leader. 1988. Community-acquired pneumonia and infection with respiratory syncytial virus. Ann. Intern. Med. 109:515516.


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Estimated frequency with which individual viral respiratory syndromes are caused by specific viral pathogens

Citation: Treanor J. 2009. Respiratory Infections, p 7-27. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch2
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Therapies of potential benefit in viral pneumonia

Citation: Treanor J. 2009. Respiratory Infections, p 7-27. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch2

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