Vroon Pieter, Roosblad Jimmy, Poese Fauzia, Wilschut Jan, Codrington John, Vreden Stephen, Zonneveld Rens
Erasmus University, Rotterdam, The Netherlands.
Clinical Laboratory, Academic Hospital Paramaribo, Paramaribo, Suriname.
IDCases. 2017 Oct 23;10:117-121. doi: 10.1016/j.idcr.2017.10.007. eCollection 2017.
Acute Zika virus (ZIKV) infection is usually mild and self-limiting. Earlier, we reported three cases of fatal acute ZIKV infection in patients without typical signs of ZIKV, but rather with criteria of systemic inflammation response syndrome (SIRS). To follow up these observations, we prospectively included patients at the emergency room with temperature instability and suspected to have acute ZIKV infection, SIRS, or both. A total of 102 patients were included of whom N = 21 (21%) were suspected of acute ZIKV infection, N = 56 (55%) of acute ZIKV infection with SIRS criteria, and N = 25 (24%) of SIRS alone. ZIKV-PCR was positive in N = 21 (20%) patients. Eight (38%) ZIKV-positive patients needed admission to the hospital of whom four (50%) presented with SIRS alone. One ZIKV-positive patient had vascular co-morbidity and died following shock and severe coagulopathy. We confirm the hypothesis that acute ZIKV infection can present atypical and severely with systemic inflammation and have lethal course particularly amongst patients with significant prior disease.
急性寨卡病毒（ZIKV）感染通常症状轻微且具有自限性。此前，我们报告了3例无典型寨卡病毒体征、而是符合全身炎症反应综合征（SIRS）标准的致命性急性寨卡病毒感染病例。为追踪这些观察结果，我们前瞻性纳入了急诊室中体温不稳定且疑似患有急性寨卡病毒感染、SIRS或两者皆有的患者。共纳入102例患者，其中21例（21%）疑似急性寨卡病毒感染，56例（55%）符合急性寨卡病毒感染合并SIRS标准，25例（24%）仅患有SIRS。21例（20%）患者的寨卡病毒聚合酶链反应（ZIKV-PCR）呈阳性。8例（38%）寨卡病毒阳性患者需要住院治疗，其中4例（50%）仅表现为SIRS。1例寨卡病毒阳性患者有血管合并症，在休克和严重凝血病后死亡。我们证实了这一假设，即急性寨卡病毒感染可表现为非典型且伴有严重全身炎症，并有致命病程，尤其是在有明显既往疾病的患者中。
