Zeller Valérie, Bricaire François
Service des maladies infectieuses et tropicales, groupe hospitalier de La Pitié-La Salpêtrière, 75651 Paris.
Rev Prat. 2003 Sep 15;53(13):1442-5.
Two types of pneumonia are well recognized during influenza: primary viral pneumonia and secondary bacterial pneumonia. Primary viral pneumonia occurs after a typical onset of influenza with rapid progression of dyspnea and cough leading to acute respiratory distress syndrome. Treatment consists of respiratory assistance, but mortality is high. Secondary bacterial pneumonia occurs more frequently in the elderly and in patients with chronic pulmonary diseases. Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae are the most frequently isolated bacteria. After an initial phase of clinical improvement, manifestations of bacterial infection with pulmonary consolidation occur. The outcome is favorable with antibiotics but depends on the patient's underlying conditions.
原发性病毒性肺炎和继发性细菌性肺炎。原发性病毒性肺炎发生在典型的流感发病后,呼吸困难和咳嗽迅速进展,导致急性呼吸窘迫综合征。治疗包括呼吸支持,但死亡率很高。继发性细菌性肺炎在老年人和慢性肺部疾病患者中更常见。金黄色葡萄球菌、肺炎链球菌和流感嗜血杆菌是最常分离出的细菌。在临床改善的初始阶段之后,会出现肺部实变的细菌感染表现。使用抗生素治疗效果良好,但取决于患者的基础状况。