病毒性肺炎(英文)ppt课件

Children who are very hypoxic or cannot feed because of respiratory distress must be hospitalized and given humidified oxygen and tube or intravenous feedings. Antibiotics, decongestants, expectorants, and steroids are of no value in routine infections, such children should be kept in respiratory isolation. Often a trial of bronchodilator therapy is geven to determine if bronchospasm coexists. Ribavirin is used for RSV infection. Although mild bronchiolitis does not produce long-term problems, some of patients hospitalizes with this infection will become asthma.
病毒性肺炎(英文)

Many viruses may produce pneumonia including those of influenza, parainfluenza viruses, measles, respiratory syncytial virus, rhinoviruses, and adenoviruses. Pathologic changes are interstitial pneumonitis, inflammation of the mucosa walls of bronchi and bronchioles, and at times secondary bacterial infection. Complications are infrequent. Symptoms vary, ranging from mild fever, slight upper respiratory infection is often present. Physical finding in the chest are frequently normal or minimally abnormal. The radiography reveals diffuse infiltration extending from one or both hilar areas usually associated with a patchy bronchopneumonia. The whit cell count is usually normal, but slight leukocytosis may be present. Viral pneumonias are treated symptomatically, antibiotics being used only if bacterial complications ensue.
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Imaging: diffuse hyperinflation and peribronchiolar thickening are most common; atelectasis and patchy infiltrates also occur in uncomplicated infection, but pleural effusions are rare. Consolidation occurs in 25% of children with lower respiratory tract disease.

Initial symptoms are those of upper respiratory infection. Low-grade fever may be present 2-3 days later. The classic disease is bronchiolitis, characterized by diffuse wheezing, variable fever, cough, tachypnea, difficult feeding, and in severe cases, cyanosis. Hyperinflation, crackles, prolonged expiration, wheezing, and retractions are present. The liver and spleen may be palpable because of lung hyperinflation but are not enlarged. There are two types of RSV pneumonia: bronchiolitis and interstitial pneumonia. Patients status of interstitial pneumonia is worse than that of bronchiolitis. Apnea may be the presenting manifestation, especially in premature infants, and in the first few months of life, it usually resolves after a few days, often being replaced by obvious signs of bronchiolitis.
Respiratory syncytial virus pneumonia

RSV is the most important cause of lower respiratory tract illness in young children, accounting for more than 70% of cases of bronchiolitis and 40% of cases of pneumonia. 2 years old, especially 2-6 months are the most commonest age group of the illness.

Rapid detection of RSV antigen in nasal or pulmonary secretions by fluorescent antibody staining or ELISA is more than 90% sensitive and specific.. These tests provide an etiologic diagnosis within several hours after the specimens are processd.