Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea.
Pediatr Pulmonol. 2012 May;47(5):505-9. doi: 10.1002/ppul.21588. Epub 2011 Oct 25.
Parapneumonic effusion has been reported to develop either in typical bacterial infection or in viral pneumonia with bacterial co-infection and to cause death. Swine-origin influenza A (H1N1) virus infection can be accompanied with pleural effusion; however, there are no reports about the significance of pleural effusion in H1N1 pneumonia. We retrospectively analyzed both the clinical characteristics and the significance of pleural effusion associated with H1N1 pneumonia in children and adolescent.
Eighty-nine patients who were admitted with H1N1 pneumonia were divided into two groups: 17 patients with pleural effusion (i.e., the effusion group), and 72 patients without pleural effusion (the non-effusion group).
Lymphopenia (P = 0.030), elevation of the C-reactive protein (P = 0.026), and positive rate of anti-sptreptolysin O titer (P = 0.040) were significantly increased in the effusion group than in the non-effusion group. In addition, the need for treatment with both oxygen (P < 0.001) and oseltamivir (P = 0.013) was significantly increased in the effusion group. However, there was no significant difference between the two investigated groups in the duration of the treatment with intravenous antibiotics, the time of fever remission calculated from admission, and the days of hospital stay. Also, there was no documented bacterial co-infection in any of the studied groups.
This result suggested that pleural effusion in H1N1 pneumonia could develop without bacterial co-infection and had mild clinical course.
细菌性肺炎或病毒性肺炎合并细菌感染可导致类肺炎性胸腔积液，从而引起死亡。甲型 H1N1 流感病毒感染可伴有胸腔积液；然而，目前尚无关于 H1N1 肺炎胸腔积液意义的报道。我们回顾性分析了儿童和青少年甲型 H1N1 肺炎合并胸腔积液的临床特征及意义。
89 例甲型 H1N1 肺炎患者分为两组：胸腔积液组 17 例（胸腔积液组），无胸腔积液组 72 例（非胸腔积液组）。
胸腔积液组淋巴细胞减少（P=0.030）、C 反应蛋白升高（P=0.026）、抗链球菌溶血素 O 滴度阳性率升高（P=0.040）均明显高于非胸腔积液组。此外，胸腔积液组需要氧疗（P<0.001）和奥司他韦治疗（P=0.013）的比例明显高于非胸腔积液组。然而，两组在静脉抗生素治疗时间、入院后退热时间和住院天数方面无显著差异。两组均未发现细菌合并感染。
该结果表明，H1N1 肺炎合并胸腔积液可在无细菌合并感染的情况下发生，且临床过程较轻。
