Najwa Al-Mously^1,, Amani Azizalrahman², Turki M. Al Harbi³, Saleh A. Altamimi⁴

Fever is one of the most common presenting complaints in paediatric emergency departments (ED). Acute viral respiratory infection is the most common findings. The aim of this study is to define types of respiratory viruses among febrile infants under 90 days attending to emergency department. Methods: In addition to sepsis workup, nasopharyngeal aspirates were collected from 265 febrile infants without an apparent source of infection. A multiplex PCR assay was used to detect 15 human viral species and subtypes. Results: Overall, 154/265 (58.1%) NPA specimens from febrile infants were positive for at least one human virus. Viral types detected were as follows: (60/265,22.6%) rhinovirus, (50/265,18.9%) respiratory syncytial virus, (28/265,10.6%) parainfluenza virus, (11/265,4.2%) influenza virus, (12/265,4.5%) coronavirus, (10/265,3.8%) metapneumo, (8/265,3%) adenovirus, (2/265,0.75%) enterovirus, and (2/265,0.75%) bocavirus. Co-detection of two viruses or more was also observed. Positive bacterial cultures were reported in 16.5%, 3.5%, and 2.8% of urine, blood and CSF samples respectively. Conclusion: Viral infections are frequent in febrile infants without an apparent source. Testing NPA for molecular identification of viruses in addition to the routine sepsis workup may help more accurate management of febrile infants. This could also limit the unnecessary use of antibiotics, and nosocomial spread of viruses, however, this needs to be further investigated.

febrile infants, under 90 days, respiratory viruses, molecular epidemiology, emergency department