Lambregts Merel M C, Alleman Maarten A, Ruys Gijs J H M, Groeneveld Paul H P
Isala Klinieken, locatie Sophia, Zwolle, The Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1067.
A 68-year-old man, immunocompromised due to non-Hodgkin lymphoma and chemotherapy, was admitted for a community-acquired norovirus infection. He developed chronic intermittent diarrhoea and cachexia. A video-capsule examination showed severe mucosal atrophy in the jejunum. The patient died eight months after the initial norovirus infection. Eight of the nine stool examinations were positive for the norovirus during this entire period. Excretion of norovirus is known to persist after the symptoms have been resolved. However, there is only one previously reported case of excretion over such a long period. Recognising a chronic norovirus infection in immunocompromised patients is vital as then complications such as mucosal atrophy with malabsorption and cachexia can be diagnosed and supportive therapy can be started. Furthermore, recognising a chronic norovirus infection is essential for preventing norovirus outbreaks. Infected patients should always be isolated, regardless of their symptoms and faecal viral load.
一名68岁男性，因非霍奇金淋巴瘤和化疗导致免疫功能低下，因社区获得性诺如病毒感染入院。他出现了慢性间歇性腹泻和恶病质。视频胶囊检查显示空肠严重黏膜萎缩。该患者在初次感染诺如病毒八个月后死亡。在此期间，九次粪便检查中有八次诺如病毒呈阳性。已知诺如病毒在症状缓解后仍会持续排出。然而，此前仅有一例关于如此长时间排出病毒的报道。认识到免疫功能低下患者的慢性诺如病毒感染至关重要，因为这样可以诊断出诸如伴有吸收不良的黏膜萎缩和恶病质等并发症，并启动支持性治疗。此外，认识到慢性诺如病毒感染对于预防诺如病毒暴发至关重要。无论感染患者的症状和粪便病毒载量如何，都应始终对其进行隔离。
