{"id":3163,"date":"2010-05-30T12:05:02","date_gmt":"2010-05-30T16:05:02","guid":{"rendered":"http:\/\/insidesurgery.com\/?p=3163"},"modified":"2010-05-30T22:16:56","modified_gmt":"2010-05-31T02:16:56","slug":"respiratory-syncytial-virus-rsv","status":"publish","type":"post","link":"https:\/\/insidesurgery.com\/2010\/05\/respiratory-syncytial-virus-rsv\/","title":{"rendered":"Respiratory Syncytial Virus (RSV)"},"content":{"rendered":"
Pathophysiology<\/strong><\/p>\n 1)<\/strong> respiratory tract disease with the most severe clinical conditions seen in newborns and infants 2)<\/strong> cause is infection with a virus in the Paramyxoviridae family 3)<\/strong> exists in types A and B with the antigenic difference owing to differences in the G protein<\/p>\n Signs and Symptoms<\/strong><\/p>\n Infants and young children<\/em> – 1)<\/strong> fever 2)<\/strong> rhinorrhea 3)<\/strong> cough 4)<\/strong> wheezing 5)<\/strong> rhonchi 6)<\/strong> rales 7)<\/strong> can progress to dyspnea, tachypnea, hypoxia Adults<\/em> – 8)<\/strong> headache 9)<\/strong> sore throat 10)<\/strong> malaise Elderly<\/em> – 11)<\/strong> pneumonia 12)<\/strong> bronchiolitis 13)<\/strong> tracheobronchitis<\/p>\n Characteristic Test Findings<\/strong><\/p>\n Radiology<\/em> – 1)<\/strong> hyperexpanded lung fields 2)<\/strong> infiltrates (can range from diffuse infiltrates to lobar consolidation) Laboratory<\/em> – 3)<\/strong> definitive diagnosis is made by isolating the virus from respiratory secretions in infants and, in older children and adults, by positive serologic titers<\/p>\n Histology\/Gross Pathology<\/strong><\/p>\n 1)<\/strong> single-stranded enveloped RNA virus 2)<\/strong> replication of virus causes fusion of neighboring cells into giant multinucleated syncytia 3)<\/strong> the major glycoproteins extending from the lipid envelope are G protein (attaches virus to cells) and F protein (facilitates the fusion of the viral and host membrane)<\/p>\n Associated Conditions<\/strong><\/p>\n 1)<\/strong> increased mortality of RSV with congenital heart disease, nephrotic syndrome, prematurity, bronchopulmonary dysplasia, immunosuppression 2)<\/strong> increased frequency of RSV with – daycare centers, transplant patients, institutionalized patients<\/p>\n Inheritance\/Epidemiology<\/p>\n 1) affects mostly infants and young children ) occurs in USA in late fall and winter and almost never seen in warmer months 3) easily transmitted person to person via fingers, fomites, and aerosols.<\/p>\n Treatment<\/strong><\/p>\n 1)<\/strong> for upper respiratory tract disease – general supportive care 2)<\/strong> for lower tract disease – suctioning, supplemental oxygen, and antibronchospastic agents 3)<\/strong> in severe cases, aerosolized ribavirin 4)<\/strong> prophylaxis in high-risk patients with IV immunoglobulin<\/p>\n Tips for USMLE<\/strong><\/p>\n 1) <\/strong>in adults, RSV reinfection is one of the causes of the “common cold” 2)<\/strong> think RSV is a 6 month-old baby is sent home from day care one day in early November with a fever, runny nose, cough, and slight wheezing on inspiration<\/p>\n","protected":false},"excerpt":{"rendered":" Pathophysiology 1) respiratory tract disease with the most severe clinical conditions seen in newborns and infants 2) cause is infection with a virus in the Paramyxoviridae family 3) exists in types A and B with the antigenic difference owing to differences in the G protein Signs and Symptoms Infants and young children – 1) fever […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[31],"tags":[1644,1645,526,660],"yoast_head":"\n