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Parainfluenza
Human parainfluenza virus; HPIVs
Parainfluenza refers to a group of viruses that lead to upper and lower respiratory infections.
Causes
There are four types of parainfluenza virus. They can all cause lower or upper respiratory infections in adults and children. The virus can cause croup , bronchiolitis , bronchitis and certain types of pneumonia.
Upper respiratory infections
The common cold most often causes a runny nose, nasal congestion, and sneezing. You may also have a sore throat, cough, headache, or other symptoms....
Croup
Croup is breathing difficulty and a "barking" cough. Croup is due to swelling around the vocal cords. It is common in infants and children....
Bronchiolitis
Bronchiolitis is swelling and mucus buildup in the smallest air passages in the lungs (bronchioles). It is usually due to a viral infection....
Bronchitis
Acute bronchitis is swelling and inflamed tissue in the main passages that carry air to the lungs. This swelling narrows the airways, which makes it...
The exact number of parainfluenza cases is unknown. The number is suspected to be very high. Infections are most common in fall and winter. Parainfluenza infections are most severe in infants and become less severe with age. By school age, most children have been exposed to the parainfluenza virus. Most adults have antibodies against parainfluenza, although they can get repeat infections.
Symptoms
Symptoms vary depending on the type of infection. Cold-like symptoms consisting of a runny nose and mild cough are common. Life-threatening respiratory symptoms can be seen in young infants with bronchiolitis and those with weak immune system.
In general, symptoms may include:
- Sore throat
- Fever
- Runny or stuffy nose
-
Chest pain, shortness of breath,
wheezing
Wheezing
Wheezing is a high-pitched whistling sound during breathing. It occurs when air moves through narrowed breathing tubes in the lungs.
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Exams and Tests
A physical exam may show sinus tenderness, swollen glands, and a red throat. The health care provider will listen to the lungs and chest with a stethoscope. Abnormal sounds, such as crackling or wheezing, may be heard.
Tests that may be done include:
-
Arterial blood gases
Arterial blood gases
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
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Blood cultures
(to rule out other causes of pneumonia)
Blood cultures
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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CT scan of the chest
CT scan of the chest
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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Complete blood count (CBC)
Complete blood count (CBC)
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
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Treatment
There is no specific treatment for the viral infection. Certain treatments are available for the symptoms of croup and bronchiolitis to make breathing easier.
Outlook (Prognosis)
Most infections in adults and older children are mild and recovery takes place without treatment, unless the person is very old or has an abnormal immune system. Medical intervention may be necessary if breathing difficulties develop.
Breathing difficulties
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
Possible Complications
Secondary bacterial infections are the most common complication. Airway obstruction in croup and bronchiolitis can be severe and even life threatening.
Airway obstruction
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
When to Contact a Medical Professional
Call your provider if:
- You or your child develops croup, wheezing, or any other type of breathing difficulty.
- A child under 18 months develops any type of upper respiratory symptom.
Prevention
There are no vaccines available for parainfluenza. A few preventive measures that may help include:
- Avoiding crowds to limit exposure during peak outbreaks
- Washing your hands often.
- Limiting exposure to day care centers and nurseries, if possible.
References
Ison MG. Parainfluenza viruses. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 158.
Weinberg GA, Edwards KM. Parainfluenza viral disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 363.
Yogev R, Hall CB. Parainfluenza viruses. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 178.
Review Date: 8/21/2016
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
