Bidiga László, Asztalos László, Fülep Zoltán, Fülesdi Béla, Méhes Gábor
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Pathologiai Intézet, Debrecen.
Orv Hetil. 2010 Apr 4;151(14):576-9. doi: 10.1556/OH.2010.28852.
The most serious complication of novel influenza virus (H1N1) infections is the progressive respiratory insufficiency caused by diffuse alveolar damage (DAD) which can be overinfected by opportunistic pathogens. Clinically manifest acute respiratory distress syndrome leads to death in the most severe forms of the disease. However, despite the H1N1 positivity determined by RT-PCR, signs of virus pneumonia could not be demonstrated in several cases belonging to the high-risk patient group, therefore, the role of the virus infection in the course of the disease remained unclear. In this paper, a case with a complicated, partially organized hemorrhagic pneumonia and DAD is presented in a patient with H1N1 virus positivity, which can be referred as a classical pulmonary change. In order to obtain correct statistical data on virus related mortality, only unambiguous cases with clear virus associated morphological changes should be considered.
新型甲型H1N1流感病毒感染最严重的并发症是由弥漫性肺泡损伤（DAD）导致的进行性呼吸功能不全，这种损伤可能会被机会性病原体重叠感染。临床上表现为急性呼吸窘迫综合征，在该疾病最严重的形式中会导致死亡。然而，尽管通过逆转录聚合酶链反应（RT-PCR）检测确定为甲型H1N1流感病毒阳性，但在一些属于高危患者组的病例中，并未发现病毒肺炎的迹象，因此，病毒感染在疾病过程中的作用仍不明确。本文介绍了一例甲型H1N1流感病毒阳性患者出现复杂的、部分机化的出血性肺炎和弥漫性肺泡损伤的病例，这可被视为典型的肺部病变。为了获得有关病毒相关死亡率的正确统计数据，应仅考虑具有明确病毒相关形态学改变的明确病例。
