以肺炎起病的痘苗病毒感染长期随访五例并文献复习

Long follow-up of 5 cases of vaccinia virus infection with pneumonia:clinical analysis and literature review

目的长期随访痘苗病毒肺炎患者,描述痘苗病毒致肺炎的影像学及临床特点。方法分析南京医科大学附属无锡市人民医院收治的5例痘苗病毒肺炎患者的临床资料,影像学特点及长期随访情况,并复习相关文献。结果5例患者均为男性,年龄在21~54岁,通过直接吸入及皮肤接触到含痘苗病毒的粉末,发病潜伏期在2~5 d。5例均有发热、肺炎表现,其中3例有疱疹。2例重症肺炎患者影像学两肺广泛斑片、结节影,轻症患者胸部CT表现为两肺散在小结节影。每间隔半年对患者进行电话随访,随访3年,所有患者预后良好,重症肺炎患者肺部遗留结节影。复习既往英文文献报道的患者,临床成聚集性发病,症状以发热、呕吐、皮疹症状为主。结论痘苗病毒通过不同的传播途径可能导致不同的临床症状,其传染性强,在实验室应用过程及工作环境中应加强安全防护。

Objective To describe the imaging and clinical features of vaccinia virus induced pneumonia by longterm follow-up.Methods The clinical data,imaging features and long-term follow-up of 5 patients with vaccinia virus pneumonia admitted to Wuxi People’s Hospital Affiliated to Nanjing Medical University were analyzed.Results All the5 patients were male,aged between 21 and 54 years.The latent period of the disease was 2 to 5 days.All the patients had fever and pneumonia,while 3 of them had herpes.Two patients with severe pneumonia showed extensive patchy and nodular shadows in both lungs.Chest CT findings of the other three patients showed scattered small nodules in both lungs.All patients were followed up by telephone every half a year for 3 years.The prognosis of all patients was good.The patients reported in the English literature were clinically clustered,with fever,vomiting and rash as the main symptoms.Conclusions Vaccinia virus may cause different clinical symptoms through different transmission routes,and its infectivity is strong.Biological protection should be strengthened in laboratory and working environment.