Introducere. La copilul sub 5 ani, morbiditatea în 2/3 de cazuri sunt afecțiunile respiratorii acute, ponderea pneumoniei comunitare (PC) fiind până la 40%. Evoluția severă este determinată adesea cu asocierea infecțiilor persistente, mai frecvent infecția virală cu citomegalovirus (CMV).
Scopul lucrării. Determinarea markerilor clinico-imunologici în evoluția PC asociate cu CMV la copii.
Material și metode. Studiu – 106 copii cu vîrsta sub 5 ani, cu PC asociată cu infecția virală cu CMV. Examinarea serologică ELISA (anti-CMV IgM, anti-CMV IgG), metoda cantitativă Mancini (IgA, IgM, IgG). Statistica: t-Student.
Rezultate. Starea gravă I lot – (35,48±1,4%, (p<0,05)), II lot – (27,27±1,3%, (p<0,01)), III lot – 12,9%. Tuse seaca – (61,29%), spastică – (45,16%), nocturnă – (58,06%) la copii din I lot. Dispnee I lot – 87,09%, II lot – 50%, III lot – 41,9%. Prezența stridorului I lot – (74,4%), II lot – (35%), III lot – (22,5%). Hipo-Ig A (I lot – 83,33±2,7%, (p≤0,05), II lot – 93,33±3,6%, (p≤0,01), III lot – 74,19±1,9%, (p≤0,05)). Hipo-Ig G (I lot – 72,2±1,6%, (p≤0,01), II lot – 83,3±2,8% (p<0,05), III lot – 83,87±2,4% (p<0,05)). Hiper-Ig M (I lot – 44,4±1,4% (p<0,001), II lot – 43,3±2,7% (p<0,01), III lot – 61,29±4,8% (p<0,05).
Concluzii. (1) Infecția CMV la copii cu PC detremină starea gravă, evoluția mai severă, instalarea insuficienței respiratorii acute și prezența a sindromului bronhoobstructiv sever. (2) Infecția CMV (69%), în studiu dovedește un impact negativ, supresiv asupra sistemul imun umoral dezvoltînd susceptibilitatea la infecții respiratorii frecvente la copii.

Introduction. Acute respiratory illnesses are the cause of morbidity in 2/3 children under 5 years old, of these cases, community acquired pneumonia (CAP) is reported in 40%. Severe and prolonged evolution of acute respiratory diseases is often determined by the association with persistent cytomegalovirus infections (CMV).
Objective of the study. Assessment of clinical and immunologic markers in children diagnosed with CAP associated with CMV infection.
Material and methods. Our study included 106 children under 5 years old with CAP associated with persistent CMV infection. These children were divided into three study groups: I – control group, II – children with acute respiratory illnesses and persistent CMV infection, III – children with acute respiratory illnesses and persistent remission of CMV infection. Immunological assessment included serological screening with ELISA method (anti-CMV IgM, anti-CMV IgG), Mancini quantitative method (IgA, IgM, IgG). Statistics: t-Student.
Results. Severe general appearance was noted in group I in 35.48±1.4% cases (p<0.05), in group II in 27.27±1.3% cases (p<0.01) and in group III in 12.9%. Dry cough was present in 61.29% children, spastic cough – in 45.16% children and nocturnal cough in 58.06% children from group I. Dyspnoea was characteristic in 87.09% children from group I – 50% from group II, and in 41.9% children from group III. Stridor was reported in 74.4% children from group I 35% children from group II, and 22.5% cases from group III. Hipo-Ig A (group I – 83.33±2.7%, (p≤0.05), group II – 93.33±3.6%, (p≤0.01), group III – 74.19±1.9%, (p≤0.05)). Hipo-Ig G (group I – 72.2±1.6%, (p≤0.01), group II – 83.3±2.8% (p<0.05), group III – 83.87±2.4%, (p<0.05)). Hiper-Ig M (group I – 44.4±1.4% (p<0.001), group II – 43.3±2.7% (p<0.01), group III – 61.29±4.8% (p<0.05).
Conclusions. (1)CMV infection in children with CAP causes severe general appearance, severe progression to acute respiratory failure, increased incidence of severe broncho-obstructive syndrome. (2) High incidence of CMV infection (69%) in our study proves a negative and suppressive impact on the humoral immune system by developing susceptibility to frequent respiratory infections.