Abstract
Objective The most common childhood convulsive disorder happens to be febrile seizure (FS),
which is an important health problem leading to economic burden and parental anxiety.
Further investigation into the etiological causes of FS will guide us for appropriate
measures during the follow-up period. The aim of study was to identify the percentage
of viral and bacterial pathogens in the etiological causes of children with FS, and
also if there is any difference between simple and complex FSs.
Methods This prospective study randomly enrolled 100 pediatric patients with FS between January
2017 and July 2017. Nasopharyngeal swabs were obtained from all children at presentation.
The respiratory panel was performed with a multiplex real-time polymerase chain reaction
method to detect the 21 most common viruses. A complete blood count, absolute neutrophil
count, absolute lymphocyte count, C-reactive protein, erythrocyte sedimentation rate,
procalcitonin, blood culture, throat culture, urine analyses, urinary culture, and
stool tests analysis were performed in all the patients.
Results During the study period, at least one virus was detected in 87% of patients. Bacterial
agents were detected in only 13% of patients. Coinfections of the viruses and bacterial
pathogens were found in 24% of patients. The most frequently detected virus was influenza
A (Inf A) (18%), followed by rhinovirus (12%). Coinfections of the viruses and bacterial
pathogens, mixed viral infections, and Inf A were common in children who experienced
complex FS. Inf A was detected in 16% of patients with simple FSs and 30% of patients
with complex FSs and a significant difference between them (p < 0.01).
Conclusion The results of this study showed that respiratory viral and bacterial pathogens are
important in the etiology of FS in children. It is considered that complex FSs may
be triggered by Inf A. The fact is viral pathogens are very common; therefore, antibiotics
must be carefully prescribed. These results also draw attention to the use of the
quadrivalent influenza vaccine in the prevention of FS related to the flu.
Keywords
children - febrile seizures - etiological causes - virus - bacteria
