一例肠道腺病毒41型感染与重症肺炎关系的临床分析

Clinical Analysis of Human Enteric Adenovirus Type 41 and Severe Pneumonia——A Case Report

目的分析肠道腺病毒与呼吸系统疾病的关系,进一步提高婴幼儿重症肺炎诊治水平。方法对重症肺炎尸检脑、肝、心、肺、肠、脾组织进行腺病毒巢式PCR检测,对PCR产物进行克隆测序;同时用免疫组织化学方法检测肺组织中3型腺病毒、支原体、衣原体、呼吸道合胞病毒、A型流感病毒、B型流感病毒的分布情况。结果免疫组织化学结果表明3型腺病毒、支原体、衣原体、呼吸道合胞病毒、A型流感病毒、B型流感病毒都为阴性。肺和肠中腺病毒巢式PCR结果为阳性,测序结果显示都为腺病毒41型。结论肠道腺病毒41型感染可能是婴幼儿重症肺炎的重要病因之一。

Objective To analysis the relationship between enteric Adenovirus infection and respiratory illness, and to further raise the capacities of severe pneumonia diagnosis and treatment in infant and children. Method Nested PCR was performed for Adenovirus analysis in autopsy brain, liver, heart, lung, intestine and spleen tissues obtained from patients died of severe pneumonia. The positive nested PCR products were cloned and sequenced. Adenovirus serotype 3, chlamydia, mycoplasma, respiratory syncytial virus （RSV）, influenza virus A and anti- influenza virus B in pulmonary tissue were also analyzed by immunohistochemistry. Result Adenovirus serotype 3, Chlamydia, Mycoplasma, RSV, Influenza virus A and Influenza virus B were all negative in autopsy pulmonary tissue detected by immunohistochemistry. There Adenovirus DNA detected in autopsy lung and intestine tissues by nested PCR were Adenovirus serotype 41. The result was confirmed by DNA sequencing. Conclusion Enteric Adenovirus serotype 41 might be a cause of pediatric severe pneumonia.