Parainfluenza Virus Treatment & Management

  • Author: Subhash Chandra Parija, MBBS, MD, PhD, FRCPath; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Apr 19, 2010
 

Medical Care

  • Supportive care is mandatory. Antiviral agents are of uncertain benefit. Anecdotal reports of possible benefit have been published, but controlled studies are lacking.
  • Treatment of croup
    • Prehospital care
      • It is paramount to control fever and to relieve respiratory symptoms.
      • Respiratory symptoms are improved by exposing children to cool night air or by inhalation of vapor droplets to soothe inflamed airways.
      • Antipyretics may be administered to control fever.
      • Moderate or severe croup requires medical evaluation in the office or ED.
    • ED care
      • Mild croup: Cool oxygen mist and control of fever are effective in the treatment of mild croup.
      • Moderate croup: Therapy includes cool oxygen mist and, possibly, orally administered glucocorticoids. If patients fail to improve, racemic epinephrine nebulization has been shown to be beneficial. Hydration must be maintained with oral fluids or with intravenous fluids, when necessary.
      • Severe croup: In cases of impending respiratory failure, intensive-care monitoring is required in addition to repeat racemic epinephrine nebulization at 1- to 2-hour intervals. Endotracheal intubation followed by a tracheotomy may be required in patients with severe respiratory obstruction.
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Consultations

Consultations may include pulmonologists and infectious diseases specialists.

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Contributor Information and Disclosures
Author

Subhash Chandra Parija, MBBS, MD, PhD, FRCPath  Director-Professor of Microbiology, Head of Department of Microbiology, Jawaharlal Institute, Postgraduate Medical Education and Research, India

Subhash Chandra Parija, MBBS, MD, PhD, FRCPath is a member of the following medical societies: Indian Academy of Tropical Parasitology, Indian Association of Biomedical Scientists, Indian Association of Medical Microbiologists, Indian Association of Pathologists and Microbiologists, Indian Medical Association, Indian Society for Parasitology, National Academy of Medical Sciences, India, and Royal College of Pathologists

Disclosure: Jawaharlal Institute of Postgraduate Medical education & Research , Pondicherry , India Salary Employment

Coauthor(s)

Thomas J Marrie, MD  Dean of Faculty of Medicine, Dalhousie University Faculty of Medicine, Canada

Thomas J Marrie, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society for Microbiology, Canadian Infectious Disease Society, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

Jeffrey D Band, MD  Clinical Professor of Medicine, Wayne State University School of Medicine; Director, Division of Infectious Diseases and International Medicine, Corporate Epidemiologist, William Beaumont Hospital

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Richard B Brown, MD, FACP  Chief, Division of Infectious Diseases, Baystate Medical Center; Professor, Department of Internal Medicine, Tufts University School of Medicine

Richard B Brown, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and Massachusetts Medical Society

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

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  5. Johnson D. Croup. Clin Evid (Online). Mar 10 2009;2009:[Medline].

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  10. Watanabe M, Mishin VP, Brown SA, Russell CJ, Boyd K, Babu YS, et al. Effect of hemagglutinin-neuraminidase inhibitors BCX 2798 and BCX 2855 on growth and pathogenicity of Sendai/human parainfluenza type 3 chimera virus in mice. Antimicrob Agents Chemother. Sep 2009;53(9):3942-51. [Medline].

  11. Gomez M, Mufson MA, Dubovsky F, Knightly C, Zeng W, Losonsky G. Phase-I study medi-534, of a live, attenuated intranasal vaccine against respiratory syncytial virus and parainfluenza-3 virus in seropositive children. Pediatr Infect Dis J. Jul 2009;28(7):655-8. [Medline].

  12. Skiadopoulos MH, Tao T, Surman SR, Collins PL, Murphy BR. Generation of a parainfluenza virus type 1 vaccine candidate by replacing the HN and F glycoproteins of the live-attenuated PIV3 cp45 vaccine virus with their PIV1 counterparts. Vaccine. Oct 14 1999;18(5-6):503-10. [Medline].

  13. Alymova IV, Taylor G, Mishin VP, Watanabe M, Murti KG, Boyd K. Loss of the N-linked glycan at residue 173 of human parainfluenza virus type 1 hemagglutinin-neuraminidase exposes a second receptor-binding site. J Virol. Sep 2008;82(17):8400-10. [Medline].

 
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