From the Guidelines
Rhinovirus and adenovirus infections in pediatric patients should be managed with supportive care, focusing on relieving symptoms and preventing complications, as these infections are typically self-limiting and do not require specific antiviral treatment. The primary approach includes ensuring adequate hydration, using acetaminophen or ibuprofen for fever and discomfort, saline nasal drops for congestion, and honey for cough in children over 12 months 1. A cool-mist humidifier can help ease breathing difficulties. It's essential to monitor for signs of severe disease, such as difficulty breathing, persistent high fever, signs of dehydration, or worsening symptoms after initial improvement, which may necessitate medical attention 1. Prevention strategies, including frequent handwashing, avoiding close contact with sick individuals, and teaching children proper respiratory hygiene, are crucial in reducing the spread of these viruses.
Key considerations in managing these infections include:
- Ensuring adequate hydration to prevent dehydration
- Using acetaminophen (10-15 mg/kg every 4-6 hours, maximum 5 doses in 24 hours) or ibuprofen (5-10 mg/kg every 6-8 hours with food) for fever and discomfort
- Utilizing saline nasal drops for congestion and honey for cough in eligible children
- Employing a cool-mist humidifier to ease breathing difficulties
- Monitoring for signs of severe disease that may require medical intervention
Given the self-limiting nature of rhinovirus and adenovirus infections, antibiotics are not recommended as they are ineffective against viral infections. The focus should be on supportive care and prevention of complications, with medical attention sought if there are signs of severe disease or worsening symptoms 1.
From the Research
Rhinovirus and Adenovirus Paediatric Infections
- Rhinovirus (RV) is one of the most common pathogens associated with bronchiolitis in infants, with over 150 types, making recurrence of RV infections typical 2.
- RV bronchiolitis has been reported to potentially contribute to the development of long-term sequelae, such as recurrent wheezing and asthma, in the pediatric population 2.
- Respiratory syncytial virus (RSV) is the most common viral cause of bronchiolitis, but there is no mention of adenovirus as a common cause of paediatric infections in the provided studies.
- Treatment of RSV bronchiolitis is mainly supportive, including maintaining oxygen saturation above 90%, hydration, and nutrition, while therapies such as bronchodilators, epinephrine, and corticosteroids are not recommended 3, 4.
- Rhinosinusitis is a common diagnosis in children, and medical management is the mainstay of treatment, with surgery required in cases of failure or complications 5.
- There is currently no licensed vaccine for rhinovirus, but antiviral drugs and small molecule inhibitors of rhinovirus infection are being researched as potential therapeutics 6.