Resume Introduction Le virus respiratoire syncytial (VRS) est rarement recherche dans les infections respiratoires de l’adulte. Ce travail en etudie la frequence et le diagnostic. Methodes Trois enquetes distinctes ont ete menees chez des adultes atteints soit d’un syndrome pseudo-grippal, d’une infection respiratoire basse communautaire ou hospitalises pour une pneumopathie infectieuse grave. La recherche du VRS a ete faite par PCR dans tous les cas et comparee a la detection antigenique et la culture dans deux enquetes. Resultats Le VRS est identifie chez 20 (11,7 %) des 170 adultes vaccines contre la grippe atteints d’un syndrome pseudo-grippal. Dans 270 infections respiratoires basses communautaires sans signes de gravite on trouve un virus dans 86 (31,8 %) cas, dont 13 VRS (4,8 %) ; un virus est detecte dans 64 (36,7 %) des 164 bronchites aigues : 11 VRS (6,3 %), 37 rhinovirus (21,3 %), 5 virus influenza A et B, et 12 autres virus ; dans les 60 bronchites chroniques surinfectees, il y a 9 rhinovirus (15 %), 2 virus parainfluenza 3 et aucun VRS ; dans les 21 pneumopathies infectieuses aigues, on trouve 1 VRS, 1 virus influenza A et 2 rhinovirus, et dans les 11 cas d’infections respiratoires basses sur poumon pathologique, 1 VRS, 1 virus parainfluenza 3 et 4 rhinovirus ; il y a au total 19 infections bacteriennes et virales associees. Enfin, dans les 51 pneumopathies infectieuses avec detresse respiratoire hospitalisees en reanimation, un virus est isole dans 17 (33,3 %) cas : 3 VRS (5,8 %), 6 virus influenza A, 3 rhinovirus, 2 adenovirus, 2 herpes simplex et un CMV ; il y a 6 infections bacteriennes associees dont 4 d’origine nosocomiale. Tous les patients infectes par le VRS sont âges et presentent un facteur de risque respiratoire ou cardiaque. Conclusions Chez l’adulte le VRS est responsable de frequents syndromes pseudo-grippaux et parfois d’infections respiratoires basses, qui peuvent etre graves et qu’il faut penser a rechercher. La technique PCR est particulierement efficace mais non disponible en routine.

Épidémiologie et diagnostic des infections à virus respiratoire syncytial de l’adulte

Virus respiratoire syncytial, métapneumovirus et virus para-influenza humains. II. Clinique et physiopathologie

Respiratory distress and bronchiolitis due to respiratory syncytial virus in an immunocompetent adult

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Respiratory distress and bronchiolitis due to respiratory syncytial virus in an immunocompetent adult