新型布尼亚病毒重复感染病例临床特点分析

Clinical characteristics of repeated infection of newbunyavirus

目的分析信阳市发热伴血小板减少综合征患者二次感染新型布尼亚病毒(Severe fever with thrombocytopenia syndrome virus,SFTSV)的发病特点。方法收集同一患者不同时间发病资料,并对资料进行描述性分析。结果两次新型布尼亚病毒核酸检测均为阳性,该患者第1次发病,发热持续时间长、临床病情重、病毒载量高、病程长;第2次发病,热程短、自觉症状轻、病毒载量低、恢复快,表明机体对SFTSV已有一定免疫,但再次感染时血清ALT、AST、LDH、CK较第1次明显升高。结论新型布尼亚病毒重复感染使机体产生免疫的同时有变态反应的参与,极其类似郭霍现象(Koch phenomenon);该患者两次感染时间间隔不到2年的时间,提示SFTSV发生变异或存在多个血清型可能,或者SFTSV感染后无法获得持久的免疫力。

Objective To analyze the characteristics of secondary infection with newbunyavirus in patients with fever and thrombocytopenia syndrome in Xinyang City.Methods The data of the same patient at different time were collected and analyzed.Result Two new bunyavirus nucleic acid tests were positive.The first onset of the patient had a long fever duration,severe clinical condition,high viral load and long course of disease;while the second onset of the patient had a short fever course,mild symptoms,low viral load and rapid recovery,indicating that the body had certain immunity to SFTSV;but the serum ALT,AST,LDH and CK were significantly higher than those of the first onset.Conclusion The repeated infection of the new bunyavirus causes the body to produce immunity with the participation of allergy,which is very similar to Koch phenomenon.The time interval between the two infections of the patient is less than 2 years,which indicates that the SFTSV may have mutation or multiple serotypes,or the SFTSV infection can not obtain lasting immunity.