病毒性肺炎(英文)

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.

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.


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 bogy

The causative organisms are coagulase-positive staphylococci aureus. From a therapeutic viewpoint they can be divided into two groups: those sensitive to penicillin G and those resistant to it. The latter pose the principal problem. furthermore, these organisms are not only resistant but also persistent. They establish themselves in the nasal passages of nurse, physicians, attendants and other personnel, or infect them in the form of furuncles or paronychiae, cross infection in common, not only in nurseries but also in wards and private pavilions. When the patients or personnel who are persistent nasal carriers go home or make their way about the community in their daily lives, they may transmit the resistant staphylococci to other.
Adenovirus pneumonia

There are over 45 types of adenoviruses, which account for 2%-10% of all respiratory illnesses. The most commonly types that produce pneumonia are 3, 7 and 11, 12. severe pneumonia may occur at all ages, but 6 months to 2 years is the most common age group of the illness, high-grade fever may be present and last for several days. Clinical manifestations include cough, wheezing, dyspnea, and cyanosis. Rales over lung may be present 4-5 days after fever and is a character of adenovirus pneumnia. Chest x-ray show bilateral peribronchial and interstitial infiltrates. Adenoviral nneumonia can be necrotizing and cause permanent lung damage, especially bronchiectasis. Respiratory adenovirus infections can be detected by serologic tests using acute and convalescent serum, but this is rarely helpful during an acute illness.

There is no specific treatment for adenovirus infections. Intravenous immune globulin(IVIG) may be tried in immunocompromised patients with severe pneumonia. There are anecdotal reports of successful treatment of immunocopromised patients with ribavirin or cidofovir, but only cidofovir inhibits adenovirus in vitro.
Staphylococcal pneumonia

Staphylococcal pneumonia is a serious pulmonary infection of childhood. Although it may occur at any age, its greatest incidence is in the first 2 years of life, especially the first year.
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.
Viral pneumonia

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.