不明原因非典型肺炎局部暴发流行26例

Local epidemic of atypical pneumonia with unknown cause: A clinical ana- lysis of 26 cases

目的:探讨不明原因非典型肺炎患者的流行病学特征和临床表现.方法:对26例集中发病的不明原因非典型肺炎患者的临床资料进行回顾性研究分析.结果:观察对象中男性18例,女性8例,平均年龄22.5岁,均为同一单位,同一大楼集体居住.主要症状为发热、感染中毒症状,呼吸道症状轻或缺如.肺部X线片均表现为多发或单发的点片状密度增高影,密度不均,边缘不清.外周血白细胞总数正常或降低;单核细胞百分比升高;引起非典型肺炎的常见已知的病原体抗体检测均阴性,全部住院隔离治疗;应用甲磺酸培氟沙星/环丙沙星+利巴韦林治疗16例,单纯抗病毒治疗8例.26例入院5d体温恢复正常.无呼吸衰竭及死亡病例.结论:本病基本特征符合非典型肺炎特点且具有较强传染性,呼吸道为主要传播途径;发病呈人群聚集性,发病后迅速出现肺部片影;潜伏期0.5～6d.症状轻微,有自愈倾向.

AIM： To investigate the epidemiological characteristics and clinical manifestations of atypical pneumonia with unknown cause. METHODS： Clinical data were retrospectively analyzed in 26 cases of atypical pneumonia with unknown cause. RESULTS： A group of 26 patients （18 males and 8 females, average age： 22.5 years） were admitted in the hospital. The patients worked at the same institution and resided in the same building. The main symptom was fever, with less or no infectiontoxic manifestations and respiratory symptoms. All the X-ray examinations showed multiple or solitary dot-massive shadows with high or inconsistent density, and the edge of the shadows was not clear. Laboratory assays demonstrated that the number of leukocytes was decreased or normal, and monocytes were increased. All the antibodies to known pathogenies were negative. The patients were isolated during the treatment, in which 16 patients were treated with antibiotics and anti-virus, 8 patients with anti- virus only. The body temperature became normal in all the patients after 5-day treatment, without respiratory failure and death. CONCLUSION： The basic features of the patients are in accord with those of atypical pneumonia with high infectiosity. Respiratory spread is the main route of transmission. The disease occurs in an aggregated population with an incubation period of 0.5 - 6 d and with slight symptoms and a tendency of spontaneous cure. Pulmonary shadows appear quickly after onset of the disease.