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Pathogenic Viruses

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This 9-month-old boy was born prematurely, requiring treatment in a neonatal intensive care unit for the first month of life. After discharge, he remained well until 3 days ago, when symptoms of a common cold progressed to cough, rapid and labored respiration, lethargy, and refusal to eat.

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On examination, his temperature was 38.5°C, respiratory rate 60/min, and pulse 140/min. Auscultation of the chest revealed coarse crackles and occasional wheezes.

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Abnormal laboratory findings included hypoxemia and hypercarbia. A chest radiograph showed hyperinflation, interstitial perihilar infiltrates, and right upper lobe atalectasis.

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Which of these viruses is the least likely cause of this baby's illness?

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A. Influenza A

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B. Parainfluenza 3

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C. Influenza C

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D. Respiratory syncytial virus

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E. Adenovirus

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This 9-month-old boy was born prematurely, requiring treatment in a neonatal intensive care unit for the first month of life. After discharge, he remained well until 3 days ago, when symptoms of a common cold progressed to cough, rapid and labored respiration, lethargy, and refusal to eat.

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On examination, his temperature was 38.5°C, respiratory rate 60/min, and pulse 140/min. Auscultation of the chest revealed coarse crackles and occasional wheezes.

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Abnormal laboratory findings included hypoxemia and hypercarbia. A chest radiograph showed hyperinflation, interstitial perihilar infiltrates, and right upper lobe atalectasis.

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The mechanism of “antigenic drift” in influenza viruses includes all but one of the following:

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A. Can involve either H or N antigens

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B. Mutations caused by viral RNA polymerase

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C. Can predominate under selective host population immune pressures

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D. Reassortment between human and animal or avian reservoirs

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E. Can involve genes encoding structural or nonstructural proteins

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This 9-month-old boy was born prematurely, requiring treatment in a neonatal intensive care unit for the first month of life. After discharge, he remained well until 3 days ago, when symptoms of a common cold progressed to cough, rapid and labored respiration, lethargy, and refusal to eat.

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On examination, his temperature was 38.5°C, respiratory rate 60/min, and pulse 140/min. Auscultation of the chest revealed coarse crackles and occasional wheezes.

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Abnormal laboratory findings included hypoxemia and hypercarbia. A chest radiograph showed hyperinflation, interstitial perihilar infiltrates, and right upper lobe atalectasis.

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Which of the following agents can be used to prevent RSV pneumonia?

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A....

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