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PubMed2004

Antibodies to selected pathogens in free-ranging terrestrial carnivores and marine mammals in Canada.

Antibody titres to selected pathogens (canine adenovirus [CAV-2], feline herpesvirus [FHV], phocine herpesvirus [PHV-1], canine distemper virus, dolphin morbillivirus [DMV], phocine distemper virus [PDV], parainfluenza virus type 3 [PI3], rabies virus, dolphin rhabdovirus [DRV], canine coronavirus, feline coronavirus, feline leukaemia virus, Borrelia burgdorferi and Toxoplasma gondii) were determined in whole blood or serum samples from selected free-ranging terrestrial carnivores and marine mammals, including cougars (Fellis concolor), lynxes (Fellis lynx), American badgers (Taxidea taxus), fishers (Martes pennanti), wolverines (Gulo gulo), wolves (Canis lupus), black bears (Ursus americanus), grizzly bears (Ursus arctos), polar bears (Ursus maritimus), walruses (Odobenus rosmarus) and belugas (Delphinapterus leucas), which had been collected at several locations in Canada between 1984 and 2001. Antibodies to a number of viruses were detected in species in which these infections have not been reported before, for example, antibodies to CAV-2 in walruses, to PDV in black bears, grizzly bears, polar bears, lynxes and wolves, to DMV in grizzly bears, polar bears, walruses and wolves, to PI3 in black bears and fishers, and to DRV in belugas and walruses.

Adenoviruses, Canine↗
PubMed2001

5'-Nor carbocyclic 5'-deoxy-5'-(isobutylthio)adenosine and a 2',3'-dideoxy-2',3'-didehydro derivative.

The inhibition of biochemical processes requiring S-adenosylmethionine as a co-factor have led to many nucleoside-based medicinal agents. Included in this group are 5'-deoxy-5'-(isobutylthio)adenosine (SIBA), a nucleoside with antiparasitic, antiviral and antiproliferative effects, and 5'-noraristeromycin, a carbocyclic-derived nucleoside with potent antiviral properties. This report brings together the structural components of these two compounds by describing both enantiomers of carbocyclic 5-nor SIBA (3 and 4). Owing to the recent interest in 2',3'-dideoxy-2',3'-didehydro nucleosides as antiviral agents, this derivative of 3 (5) is also described. All three compounds were screened against a variety of viruses and were found to be inactive at high concentrations or at limiting concentrations for the screening methods. The viruses subjected to 3-5 were herpes simplex virus types 1 and 2, human cytomegalovirus, vaccinia virus, vesicular stomatitis virus, respiratory syncytial virus, varicelIa zoster virus, coxsackie virus, parainfluenza-3 virus, sindbis virus, punta toro virus, reovirus-1, human immunodeficiency virus, influenza virus types A and B, adenovirus type 1 and measles virus. These results suggest that the C-5' methylene of the C-5' thio-based carbocyclic nucleosides is important for their antiviral properties.

Adenosine↗
PubMed1991

Detection of cattle infected with bovine viral diarrhea virus using nucleic acid hybridization.

A ribonucleic acid (RNA) hybridization assay to identify cattle infected by bovine viral diarrhea virus (BVDV) is described. The RNA probe was derived from the coding region at the 3' end of the genome of the NADL strain of BVDV. Total RNA from infected cell cultures or peripheral blood leukocytes from suspect animals was extracted and applied to nylon membranes with a slot blot apparatus. Peripheral blood leukocytes were tested concurrently for BVDV by virus isolation. The results of hybridization and virus isolation were in agreement for 92% of the cases. When compared with virus isolation, hybridization had a sensitivity of detection of 59.5% and a specificity of 95%. Cross-reactivity to RNA extracts of border disease virus-infected cells was noted. No cross-reactivity was detected to other common bovine viruses (bovine herpesvirus-1, bovine respiratory syncytial virus, parainfluenza-3 virus, and bluetongue virus), to viruses classified in related families (equine arteritis virus and Venezuelan equine encephalitis virus), or to viruses having similar genomic organization (dengue virus type 2 and Japanese encephalitis virus).

Animals↗
PubMed1999

Sensitivity comparison for detection of respiratory bovine coronaviruses in nasal samples from feedlot cattle by ELISA and isolation with the G clone of HRT-18 cells.

A monoclonal antibody-based capture enzyme-linked immunosorbent assay (ELISA) was developed to detect respiratory bovine coronavirus (RBCV) antigens in nasal swabs collected from cattle showing signs of respiratory tract disease following shipping. These samples had been previously tested for RBCV by inoculation of G clone cultures of human rectal tumor cells (HRT-18G) and for bovine herpes virus 1, parainfluenza virus 3, bovine adenovirus, bovine respiratory syncytial virus, and bovine viral diarrhea virus on other specifically permissive cell cultures. RBCV has not previously been recognized as an important etiological factor in the bovine respiratory disease complex of feedlot cattle. Thirty of 100 samples tested positive for RBCV antigen by capture ELISA in contrast to 38 of 100 samples that yielded RBCV isolates in G clone cells. Samples yielding other bovine respiratory viruses in the absence of RBCV were negative in the capture ELISA, which was based on the use of a single monoclonal antibody that recognizes one RBCV epitope on the S glycoprotein with the broadest reactivity with different strains of RBCV tested. Some RBCV strains may not be detected by this ELISA, which may account for the higher percentage of RBCV-infected cattle detected by RBCV isolation. However, the ELISA was simple to perform, sensitive, and specific and was more rapid than virus isolation. This assay will be useful for processing large numbers of field samples in future epidemiologic and diagnostic studies of RBCV infections of cattle.

Animals↗
PubMed2006

Viral infections in patients with hematological malignancies.

Viral infections are important causes of morbidity and mortality for patients with a hematological malignancy. However, the true incidence and consequences of viral infections for these patients who undergo conventional nontransplant therapy are poorly defined. The difference in incidence and outcome of viral infections among patient groups is wide, but dependent upon the intensity and duration of T-cell-mediated immune suppression. Infections caused by cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), respiratory syncytial virus (RSV), parainfluenza viruses and influenza viruses have been intensely studied, yet newly recognized aspects of these viral infections including late CMV infection; the emergence of new viral pathogens (human herpesvirus-6, BK virus, adenovirus, and human metapneumovirus); the development of molecular diagnostic techniques, and the potential of new agents for viral prophylaxis (maribavir), or preemptive therapy (valganciclovir) form the basis of this review. Well-designed prospective studies are needed to better clarify the spectrum of these viral infections and develop effective prevention and treatment strategies. Yet the increased use of agents like alemtuzumab that induce profound T-cell depletion demands that we develop a better understanding of viral infections that occur in patients with hematological malignancy who receive nontransplant therapy.

Antineoplastic Agents↗
PubMed2003

Synthesis, antiviral and cytotoxic activity of 6-bromo-2,3-disubstituted-4(3H)-quinazolinones.

In the present study, a series of 6-bromo-2,3-disubstitued-4(3H)-quinazolinones was synthesized by condensation of 6-bromo-2-substituted-benzoxazin-4-one with trimethoprim, pyrimethamine and lamotrigine. The chemical structures of the synthesized compounds were confirmed by means of IR, (1)H-NMR and mass spectral and elemental analysis. The antiviral activity and cytotoxicity of the compounds were tested in E(6)SM (Herpes simplex-1 KOS, Herpes simplex-1 TK-KOS ACV, Herpes simplex-2 G, Vaccinia virus, Vesicular stomatitis virus, Parainfluenza-3 virus, Reovirus-1, Sindbis virus, Coxsackie virus B4 and Punta Toro virus) and HeLa cell culture (Vesicular stomatitis virus, Coxsackie virus B4 and Respiratory syncyticla virus). Investigation of anti-HIV activity was done against replication of HIV-1 (HTLV-III B LAI) in MT-4 cells. 6-Bromo-2-phenyl-3-[(4-amino-5-(4-chlorophenyl)-6-ethylpyrimidin-2-yl]-4(3H)-quinazolinone (4) exhibited the most potent antiviral activity with a MIC of 1.92 microg/ml against vaccinia virus in E(6)SM cell culture. The other compounds did not exhibit antiviral activity nor afford significant cytoprotection to the E(6)SM and HeLa cell culture when challenged with the viruses. The study implies that 4 may possess activity against Pox viruses including variola. In the anti-HIV study, 6-bromo-2-methyl-3-[(4-amino-5-(4-chlorophenyl)-6-ethylpyrimidin-2-yl]-4(3H)-quinazolinone (3) and 6-bromo-2-phenyl-3-[(4-amino-5-(4-chlorophenyl)-6-ethylpyrimidin-2-yl]-4(3H)-quinazolinone (4) exhibited the least cytotoxic concentration (0.424, 0.461 microg/ml) which is an index of the infective viability of mock infected MT-4 cells with HIV-1. None of the compounds exhibited significant anti-HIV activity.

Anti-HIV Agents↗
PubMed1997

A serological indication of the existence of a guineapig poliovirus.

Attempts were made to clarify whether laboratory guineapigs may harbour a poliovirus which, in 1911, was described as the cause of a disease called guineapig lameness. By the use of ELISA for antibodies against the poliovirus, Theiler's murine encephalomyelitis virus (TMEV), it was shown that two pet shop guineapigs suffering from lameness had extremely high titres against poliovirus, while healthy guineapigs from the same pet shop were negative. Clearly positive results were also found in 35 out of 152 laboratory guineapig sera. Positive results were found in only two out of six breeding centres, but in three out of three experimental units, all of which purchased guineapigs from one of the seropositive breeding colonies. The diseased guineapigs recovered fully after treatment with vitamins in the drinking water, a treatment used for guineapig lameness by small animal practitioners. A theory that vitamin C deficient guineapigs are, due to an impaired steroid secretion, predisposed to succumbing to infection and develop demyelinating disease similar to that in TMEV infected mice is discussed briefly. Guineapig sera were also tested serologically for other infections. Antibodies against lymphocytic choriomeningitis virus, Clostridium piliforme and Toxoplasma gondii were not found, but one breeding colony was infected with adenovirus, pneumonia virus of mice, reovirus type 3, Sendai virus, parainfluenza (simian) virus type 5 and Encephalitozoon cuniculi. Two other breeding colonies were infected with both reovirus type 3 and E. cuniculi. In all three experimental units infection with adenovirus was observed, and in two of these Sendai virus and E. cuniculi antibodies were also found. The pet shop guineapigs were infected with adenovirus, reovirus type 3 and E. cuniculi.

Animals↗
PubMed2004

Incidence of outpatient visits and hospitalizations related to influenza in infants and young children.

OBJECTIVE: The Advisory Committee on Immunization Practices currently encourages influenza vaccination for all children aged 6 to 23 months when feasible, based on studies that have demonstrated that young children have high hospitalization rates attributable to influenza. The Advisory Committee on Immunization Practices recently voted to recommend influenza vaccination for all children beginning during the 2004-2005 influenza season; information on the rate of outpatient visits due to influenza is needed to better evaluate the potential health impact and cost-effectiveness of the recommendation. We estimated the incidence of outpatient visits as well as hospitalizations for specific acute respiratory illnesses and for influenza-associated outpatient-visit and hospitalization rates among healthy infants and children in a Massachusetts health maintenance organization. DESIGN/METHODS: Surveillance data were used to identify when influenza viruses, respiratory syncytial viruses, and parainfluenza viruses were circulating in the greater Boston area during 1994-2000. Using computerized medical records, we identified outpatient visits and hospitalizations for selected respiratory illnesses. Outpatient-visit rates and hospitalizations attributed to influenza were calculated by subtracting the rate of visits during the periseasonal period from the rate of visits during the influenza period. Rates were stratified by age and risk for complications from influenza. RESULTS: Between 1994 and 2000, there were 188 139 outpatient visits and 885 hospitalizations for respiratory illnesses in the study population. Among healthy children aged 6 to 23 months, the rate per 100 person-months for outpatient visits during influenza periods was 14.5 (95% confidence interval [CI]: 13.9 to 15.1), and the excess rate that could be attributed to influenza compared with the periseasonal period was 1.8 (95% CI: 1.1 to 2.4). Among healthy children, the rate of hospitalizations for acute respiratory disease was 10.4 per 10 000 person-months (95% CI: 6.0 to 17.0), and the rate that could be attributed to influenza when compared with the periseasonal baseline period was 3.9 (95% CI: -2.0 to 0.0). Among children who were at high risk for complications from influenza, the rate of outpatient visits per 100 person-months was 28.7 (95% CI: 26.6 to 30.9) during influenza periods. The rate of hospitalizations among high-risk children was 44.6 per 10 000 person-months (95% CI: 19.0 to 17.0). CONCLUSION: Influenza season is associated with a substantial increase in outpatient visits by healthy children. These estimates of outpatient visits for influenza will help quantify the potential health benefits and cost savings from influenza vaccination of healthy children aged 6 to 23 months.

Adolescent↗
PubMed2002

Antivirals for influenza: what is their role in the older patient?

Influenza infection is a cause of high morbidity and mortality in the elderly living in the community or in long-term care facilities. Yearly immunisation is the most important means for prevention of infection. However, protection by vaccination in the elderly is incomplete, and influenza infections and outbreaks in long-term care facilities still occur. Symptoms of influenza include fever, chills, headache, myalgia and respiratory symptoms. These clinical features overlap considerably with other co-circulating respiratory viruses such as respiratory syncytial virus and parainfluenza virus. Elderly and debilitated patients with influenza may present with less prominent respiratory symptoms and may present only with fever, lassitude and confusion. Antiviral prophylaxis and treatment with amantadine and rimantadine have been given in the past but adverse effects and early development of drug resistance have limited their use. The newer antivirals zanamivir and oseltamivir are equally effective and have the advantage of being well tolerated and active against both influenza A and B without the development of resistance. However, they are costly. Early identification and diagnosis of influenza illnesses are crucial since treatment with antiviral agents should be started within 48 hours of the beginning of illness.

Acetamides↗
PubMed1988

Serologic study of febrile upper respiratory tract infections in adults.

We prospectively studied serum antiviral antibody response in adult patients with febrile upper respiratory tract infections. Paired sera were obtained in 158 patients from January 1982 to December 1983. Eighteen patients (11.4 percent) showed a significant antibody rise in the convalescent phase of the disease compared to the acute phase. Significant antibody rise was observed against all viruses examined: influenza viruses type A and B, adenovirus type 3, respiratory syncytial virus, and parainfluenza viruses type 1, 2 and 3. Two patients responded simultaneously to two viruses. Serum interferon was detected in acute phase of the disease in 4 of 8 patients examined in whom viral infections were proved. Detected interferon was alpha type.

Adenovirus Infections, Human↗
PubMed1993

Serum viral antibody titer in vestibular neuronitis.

Fifty-seven cases of vestibular neuronitis were evaluated for viral infection by means of serum antibody titer. The viruses tested were herpes simplex virus, varicella-zoster virus, cytomegalovirus, EB virus, adenovirus, influenza virus A, influenza virus B, parainfluenza virus 3, mumps virus, rubella virus and measles virus. Paired sera were examined in 49 cases among 57 cases, 26 cases showed significant change (four-fold or greater change) in viral antibody titer. Only one case (53-year old female) showed high HSV 1 IgM antibody level by ELISA method, so the vestibular neuronitis in this case was assumed to have a close relation to viral infection.

Adolescent↗
PubMed1999

The associations of viral and mycoplasmal antibody titers with respiratory disease and weight gain in feedlot calves.

Blood samples from 32 groups of calves (n = 700) were taken on arrival and after 28-35 days at the feedlot. Eleven groups were housed in feedlots in Ontario, and 21 groups in feedlots in Alberta. Serum antibody titers to bovine viral diarrhea virus (BVDV), bovine respiratory syncytial virus (BRSV), parainfluenza virus type 3 (PIV-3), infectious bovine rhinotracheitis virus (IBRV), Mycoplasma dispar and M. bovis, plus data on bovine corona virus (BCV) from a previous study were investigated for their association with the risk of bovine respiratory disease (BRD), and with 28-day weight change, both before and after controlling for titers to Pasteurella haemolytica and Haemophilus somnus. Exposure to IBRV and M. bovis was infrequent, and although exposure to PIV-3 was more common, none of these agents had important associations with BRD. Higher titers to BVDV, BRSV, and BCV on arrival were associated with reduced risks of BRD and increased weight gains. However, there was some variation in these relationships and higher arrival titers to BVDV and BRSV in a subset of the calves were associated with increased risks of BRD. Titer increases to BVDV were associated with a higher risk of BRD and lower weight gains. Titer increases to BRSV were not usually associated with the occurrence of BRD, but titer increases to BRSV in a subset of calves that were vaccinated against BRSV, on arrival, were associated with an elevated risk of BRD. Of all the agents studied, BVDV had the most consistent associations with elevated risk of BRD and lower weight gains. Higher BRSV arrival titers were related to lower risk of BRD and higher weight gains; in some instances titer increases to BRSV were associated with higher BRD risk. Higher titers to BCV on arrival were related to reduced risks of BRD. Practical ways of adequately preventing the negative effects of these agents are still needed.

Animals↗
PubMedDate not supplied

Viral infection and allergy: lower airway.

Acute asthma exacerbations in adults and children are triggered commonly by viral upper respiratory infections. The main culprits are respiratory syncytial virus and parainfluenza virus in young children and rhinovirus in older children and adults. Recent investigations in multiple laboratories have increased our understanding of the nature of this relationship. Postulated mechanisms include a viral modulation of airway epithelial and inflammatory cell function with the release of proinflammatory cytokines and mediators, airway microvascular endothelial cell function leading to airway wall edema, airway smooth muscle cell functions, and neural regulation of airway tone via either enhanced parasympathetic efferent neuronal activity, activation of the release of bronchoactive neuropeptides from sensory c-fibers in the airways, or modulation of the influence of the nonadrenergic/noncholinergic neuronal system on airway tone. There also is evidence that rhinoviruses may directly infect the lower airways. These potential mechanisms likely relate to, are superimposed on, and potentiate preexisting inflammatory and immune responses that are characteristic of the atopic asthmatic airway. Undoubtedly, future efforts will be aimed at the prevention of asthma exacerbations via well-targeted and well-conceived strategies for prevention and/or treatment of upper respiratory infections.

Asthma↗
PubMed1992

Viral pneumonia in the immunocompromised adult with neoplastic disease: the role of common community respiratory viruses.

Until recently, the viruses most often identified in lower respiratory tract infections among immunocompromised adults with neoplastic disease have been the herpesviruses (cytomegalovirus, herpes simplex virus, varicella-zoster virus, human herpesvirus-6) and adenovirus. These viral pneumonias occur with greater frequency and/or severity among these adults than among immunocompetent adults. During the last decade, mounting evidence has suggested that the RNA viruses that commonly cause lower respiratory tract disease in the general population, namely influenza virus, respiratory syncytial virus, and parainfluenza virus, are also an important cause of serious community-acquired and nosocomial lower respiratory tract disease among immunocompromised adults. Because these infections are associated with considerable morbidity and mortality and are potentially preventable and treatable, it is important that they be recognized and treated promptly. Various therapies have been tried with some reported success, including amantadine (specifically for influenza A), ribavirin, and intravenous immunoglobulin. The optimal therapy or combination of therapies for these infections among immunocompromised adults remains to be defined in controlled trials.

Adult↗
PubMed2003

[SARS-associated coronavirus gene fragments were detected from a suspected pediatric SARS patient].

UNLABELLED: A Special "Fever and Cough" Clinic was set up at the Children's Hospital Affiliated to Capital Institute of Pediatrics for children with symptoms of fever and cough in late April when the severe acute respiratory syndrome (SARS) epidemic was at its peak in Beijing to separate the children with fever from others during their visit to the Outpatient Department. OBJECTIVE: For patients with fever, normal or low count of white blood cell and with suspected pneumonia suggested by X-ray, it was urgent to determine the etiological agents of the diseases before they were admitted to the hospital. METHODS: Throat swabs or nasopharyngeal aspirate specimens were collected from those patients and common respiratory virus antigens including influenza virus A and B, respiratory syncytial virus, adenovirus, parainfluenza virus types I, II, and III were tested by indirect immunofluorescent assay. The patients with atypical pneumonia diagnosed by X-ray and evidences of common respiratory virus infection were admitted to the regular ward for children with respiratory diseases. Children with pneumonia demonstrated by X-ray and negative for common respiratory viruses were admitted to the isolated ward for suspected SARS patients for the first step and further viral etiological studies were requested. RT-PCR was performed for those patients to detect gene fragments of human metapneumovirus (HMPV), rhinovirus (RhV) and enterovirus (EV) in their specimens. Nested RT-PCR was also developed to detect SARS coronavirus gene fragment from the specimens. Primer sequences for SARS virus detection with the PCR were selected according to the primer sequences published online by WHO on April 18, 2003. All the primers derived from the sequence at the 1b frame of coronavirus replicase gene and products with a size of 368 or 348 bp were expected with 2 different primer pairs. RESULTS: Amplicons with the sizes of 368 bp and 348 bp were obtained from a throat swab specimen collected from a 17 years old girl, who was admitted to the isolated ward because of high fever (39.5 degrees C) for 7 days, cough for 2 days, low WBC count, and pneumonia shown by X-ray when she visited the "Fever and Cough" Clinic, and without known history of contact with probable SARS patient. Antigens for the common respiratory viruses were all negative, RT-PCR for HMPV, RhV and EV were also negative while RT-PCR with different primer pairs for SARS virus were all positive which indicated that SARS coronavirus gene fragments were amplified from the specimen from this girl. The amplified fragment with a size of 368 bp was sequenced and the sequence was compared with those in the GenBank. The sequence shared 100% homology with the sequences from 1b frame of replicase genes from all 17 of SARS coronaviruses published in the GenBank so far, and shared very low homology with 2 reference strains of human coronavirus as well as other animal coronaviruses. The serum collected before her discharge from the hospital (19 days after the onset of the disease) showed SARS specific IgM and IgG antibodies. CONCLUSION: These data indicate that the patient was a confirmed case of SARS. It is of great importance to differentiate SARS patients from those infected with common respiratory viruses during SARS epidemic, especially for pediatric patients, because most of the patients visiting the outpatient department present with the symptoms of fever, cough and normal WBC count. The data mentioned above indicate that antigen and gene detections for those common respiratory viruses are useful methods for the differentiation to avoid the spread of SARS.

Adolescent↗
PubMed1992

Use of monoclonal antibodies for rapid diagnosis of respiratory viruses: memorandum from a WHO meeting.

A monoclonal antibody diagnostic kit (using immunofluorescence) to detect directly viral antigens of respiratory syncytial virus, influenza virus A, influenza virus B, parainfluenza viruses (types 1, 2, and 3), and adenovirus has been developed by WHO. During 1990 and 1991 a total of 16 laboratories in different parts of the world were invited to test the kit in clinical use. This Memorandum summarizes the results obtained as well as the discussions and recommendations made by participants at a WHO Consultation on Global Surveillance of Respiratory Viruses, held in Geneva on 25-27 March 1992.

Antibodies, Monoclonal↗
PubMedDate not supplied

[Coronavirus infection in immunodeficient patients with hemoblastosis and deficient hemopoesis].

Coronavirus infection (CVI) was studied in 227 patients hospitalized in the clinic of the Research Institute of Hematology and Transfusiology in 1993-2003 with diagnosed acute and chronic leucosis, multiple myelogenic disease and aplastic anemia. Their blood sera and secretions of the nasal cavity were examined in the indirect hemagglutination (IHA) test with dried standard erythrocyte diagnostic preparations. CVI was shown to be activated in three year cycles in immunodeficient patients, which occurred, respectively, in 66.1, 56.9, 47.8 and 51.6% of cases in the above mentioned groups of patients. In 87% of cases CVI was associated with other respiratory pathogens, the following being prevailed: respiratory syncytial virus (37.9%), parainfluenza virus (32.2%) and Mycoplasma pneumoniae (36.8%). CVI was provoked by such factors as the course of the main disease and specific treatment, previous respiratory infections of other etiology with M. pneumoniae infection playing the leading role (60%). The most severe course of CVI was observed in patients with acute leucosis (in 75% of cases accompanied by lesions of lower respiratory tracts). The use of the highly sensitive IHA test made it possible to determine the potential for both serum and local antibodies production in the patients under observation.

Anemia, Aplastic↗
PubMedDate not supplied

Influenza B virus associated pneumonia: report of one case.

Influenza A virus is a more common cause of pneumonia than influenza B virus. Influenza virus pneumonia complicated with acute respiratory distress syndrome (ARDS) is rare and has a high mortality rate. In addition to pneumonia, influenza occasionally causes neurologic, cardiac, renal, or muscular complications. Hepatic involvement in influenza virus infection has been rarely reported. We reported the case of a 7-year-old girl who was initially treated for upper respiratory tract infection, but she was transferred to the pediatric intensive care unit for intubation and ventilation after her condition deteriorated to lobar pneumonia with ARDS and liver function impairment within 7 days. Influenza B virus infection was confirmed by virus culture and serological study. Respiratory viruses, such as respiratory syncytial virus, adenovirus, influenza virus, and parainfluenza virus, are common causes of pneumonia in children; moreover, they should be considered especially in the presence of persistent leukopenia, low CRP value, lack of growth of bacterial cultures, and poor response to antimicrobial therapy. We should describe its course, diagnosis, and treatments in detail; furthermore, we reported this case to emphasize that influenza B virus may cause transient liver dysfunction and it is an etiology of pneumonia as well as ARDS.

Child↗