Deaths associated with respiratory tract infection in childhood.

Abstract

Of 22 children with respiratory tract infections who died in Newcastle and Dhruam hospitals during a 27-month period, 19 were less than 1 year old. Nine had major congenital abnormalities. Bacterial infections were apparently responsible for only 6 of the 22 deaths. Respiratory syncytial virus was the only potential pathogen isolated from 8 of the children; it was isolated from necropsy lung specimens in seven of these cases, including all 4 cases of pneumonia with no apparent bacterial cause; and it was also isolated from the upper respiratory tract and the lung of a child with hemophilus epiglottis. No other viruses were incriminated in any of the 22 cases. Sudden and substantially irreversible collapse was a common feature, especially in the cases not apparently caused by bacteria. Investigation of the blood-gas levels and biochemical changes in such children is suggested as the most promising approach to improved management.