COVID-19疫情期间成人水痘-带状疱疹病毒性肺炎1例并文献复习

Varicella-zoster virus pneumonia in adult during COVID-19 epidemic period:a case report and literature review

目的分析成人水痘-带状疱疹病毒性肺炎(VZVP)的临床及影像特征并复习相关文献,以提高对该疾病的认识。方法回顾性分析1例新型冠状病毒肺炎(COVID-19)疫情期间作为疑似病例收住院进行隔离观察治疗的成人VZVP病人的临床病史、实验室检查及CT检查等资料,并复习VZVP的相关文献报道。结果首诊CT平扫影像上可见双肺胸膜下及支气管旁多发的不规则磨玻璃密度影及小结节影(5~10 mm),部分结节周围可见晕征;病灶未见明显分叶及毛刺,部分病灶内可见含气支气管征,未见钙化;未见纵隔淋巴结增大和胸腔积液。经治疗后复查双肺内结节基本吸收消失且未见钙化灶。结论成人VZVP少见,通常为接触水痘病人感染水痘-带状疱疹病毒(VZV)而发病,主要影像表现为双肺多发结节并伴有晕征。

Objective The clinical and imaging characteristics of adult varicella zoster virus pneumonia(VZVP)were analyzed and the relevant literatures were reviewed to improve the understanding of the disease.Methods Retrospective analysis was performed on the clinical history,laboratory examination and CT examination of an adult VZVP patient admitted to hospital for isolation observation and treatment as a suspected case of COVID-19,and relevant literature reports on VZVP were reviewed.Results Multiple bilateral irregular ground glass density shadows and small nodules(5-10 mm)could be seen in the subpleural and peribronchial zones on the first CT scan image.Halos could be seen around some of the nodules,and no obvious lobules or burrs were found.Some lesions showed air bronchogram sign,and no calcification was identified.No mediastinal lymph node enlargement and pleural effusion were observed.After treatment,the bilateral nodules were basically disappeared and no calcification was observed.Conclusion Adult VZVP is rare,and people usually get infected by expose to varicella zoster virus.The main imaging manifestation is multiple bilateral nodules accompanied by halos.