婴幼儿巨细胞病毒感染31例临床分析

Clinical Analysis on 31 Infants with Cytomegalovirus Infection

目的提高对巨细胞病毒(CMV)感染的认识。方法回顾性分析31例CMV感染患儿的症状、体征、诊疗情况等临床资料。结果31例中有22例先误诊后确诊,其中4例先误诊为支原体肺炎,3例误诊为军团菌肺炎,3例误诊为结核,3例误诊为传染性单核细胞增多症,2例误诊为衣原体肺炎,2例误诊为黄疸型肝炎,2例误诊为溶血性贫血,2例误诊为秋季腹泻,1例误诊为白血病。结论提高对CMV感染的认识是防止漏/误诊的前提。对于有呼吸道症状,有黄疸、肝脾肿大、贫血,肝功能异常或腹泻等,但缺乏细菌、支/衣原体、结核等病原感染依据者,应考虑巨细胞病毒感染的可能,积极作病毒分离或血清CMV特异性抗体检查,做到早诊断早治疗。

Objective To improve the cognition of the cytomegalovirus （CMV） infection. Methods The clinical data （symptoms and signs,diagnosis and treatment, etc. ） of 31 infants with CMV infection was analyzed retrospectively. Results 22 patients were confirmed after misdiagnosis at first. 4 patients firstly were misdiagnosed as mycoplasmal pneumonia,3 as leginellosis pneumonias ,3 as tuberculosis, 3 as infectious mononucleosis ,2 as chlamydial pneumonias ,2 as icteric hepatitis ,2 as hemolytic anemia,2 as rotavirus diarrhea, 1 as leukemia. Conclusions Enhancing the understanding of the cytomegalovirus（CMV） infection is the premise to prevent from missed diagnosis or misdiagnosis. For those who have a symptom of breath ,jaundice and big swollen liver and spleen, anemic, the liver function exceptional or diarrhea etc, but without the attestation infected from germs, mycoplasmas,ehlamydias,tuberculosis etc. the possibility of cytomegalovirus （CMV） infection should be considered, the virus separating or the serum CMV particular antibodies should be checked actively in order to diagnose and treat early.