水痘：成人的临床表现及并发症

Chickenpox: presentation and complications in adults.

作者信息

Abro Ali Hassan, Ustadi Abdulla Muhammed, Das Kirpal, Abdou Ahmed Muhammed Saleh, Hussaini Hina Syeda, Chandra Fatma Saifuddin

机构信息

Infectious Diseases Unit, Rashid Hospital Dubai, United Arab Emirates.

出版信息

J Pak Med Assoc. 2009 Dec;59(12):828-31.

PMID:20201174

Abstract

OBJECTIVE

To describe the clinical manifestations laboratory findings and frequency of complications in adult chickenpox patients admitted in the hospital.

METHODS

This was a hospital based descriptive study, conducted at the Infectious Diseases Unit, Rashid Hospital Dubai, UAE, from March 2005 to February 2008. The study was designed to include demographics (age, sex, nationality); clinical information, radiological and biochemical changes observed in each patient and data was entered into the proforma separately. Full blood count, urea, electrolytes and blood sugar were done for all the patients, whereas, other tests were carried out when and where it was indicated. Patients were treated according to the standard protocol for the management of Chickenpox and its complications.

RESULTS

A total of 102 adult patients were entered into the study. The main presenting symptoms were itchy skin rash, fever, cough, sputum, breathlessness, throat pain, vomiting, abdominal pain, confusion and headache. Whereas, the most common complications observed were raised Alanine aminotransferases (ALT) levels (51.9%) and the levels were greater than 10-folds of normal value in 4.9%, thrombocytopenia (42.1%), varicella pneumonia (28.4%), skin infection (25.4%), septicaemia (10.7%), Encephalitis/Meningitis (8.8%), Acute Respiratory Distress Syndrome (ARDS) (6.8%), acute renal failure (2.9%) and acute hepatic failure (1.9%). The frequency of varicella pneumonia was noted to be higher in males, older age group (p < .005), smokers (p < .002) and patients with respiratory symptoms (p < .0001). Total five (4.9%) patients expired, whereas, mortality rate was 17.2% in varicella pneumonia patients and 45.5% in mechanically ventilated patients.

CONCLUSION

Chickenpox in adults causes severe systemic manifestations leading to high frequency of complications with increased mortality rate, particularly in the older age group and in smokers who develops varicella pneumonia and require mechanical ventilation.

摘要

目的

描述住院成年水痘患者的临床表现、实验室检查结果及并发症发生率。

方法

这是一项基于医院的描述性研究，于2005年3月至2008年2月在阿联酋迪拜拉希德医院传染病科进行。该研究旨在纳入人口统计学信息（年龄、性别、国籍）；每位患者观察到的临床信息、放射学和生化变化，并将数据分别录入表格。所有患者均进行了全血细胞计数、尿素、电解质和血糖检查，而其他检查则在有指征时和相应部位进行。患者按照水痘及其并发症的标准治疗方案进行治疗。

结果

共有102名成年患者纳入研究。主要表现症状为皮肤瘙痒性皮疹、发热、咳嗽、咳痰、呼吸困难、咽痛、呕吐、腹痛、意识模糊和头痛。而观察到的最常见并发症为丙氨酸转氨酶（ALT）水平升高（51.9%），其中4.9%的患者水平高于正常值的10倍，血小板减少（42.1%），水痘肺炎（28.4%），皮肤感染（25.4%），败血症（10.7%），脑炎/脑膜炎（8.8%），急性呼吸窘迫综合征（ARDS）（6.8%），急性肾衰竭（2.9%）和急性肝衰竭（1.9%）。水痘肺炎的发生率在男性、老年组（p <.005）、吸烟者（p <.002）和有呼吸道症状的患者中较高（p <.0001）。共有5名（4.9%）患者死亡，水痘肺炎患者的死亡率为17.2%，机械通气患者的死亡率为45.5%。