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巴西亚马逊州特菲疑似登革热患者中人类细小病毒 B19 基因型 1。

Human parvovirus B19 genotype 1 in suspected dengue patients of Tefé, Amazonas State, Brazil.

机构信息

Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Gerência de Virologia, Manaus, AM, Brasil.

Fundação Oswaldo Cruz Amazônia, Instituto Leônidas e Maria Deane, Manaus, AM, Brasil.

出版信息

Rev Soc Bras Med Trop. 2019 Sep 5;52:e20190304. doi: 10.1590/0037-8682-0304-2019.

Abstract

INTRODUCTION

Human parvovirus B19 (B19V) is a common pathogen, which on infection causes variety of clinical conditions from benign self-limiting exanthematous disease and other similar pathologies to fetal death.

METHODS

We collected 341 serum samples between the first and fourth day after the onset of symptoms from all patients suspected of dengue fever who were attended at Regional Hospital of Tefé. Initially, patients were screened for malaria by blood smear test and negative samples were sent to Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) situated in Manaus (AM) for dengue testing using semi-nested multiplex PCR. Further, we investigated 44 malaria and dengue-negative samples of children for B19V DNA by nested-PCR. Positive samples were analyzed by BLAST against entire public non-redundant nucleotide database and genotyped by phylogenetic analyses using neighbor-joining clustering method.

RESULTS

Eight samples (18.2%) were found to be PCR positive. Fever, headache, ocular pain, and/or muscle pain were reported as the most frequent symptoms by the patients and none were diagnosed with rash at the time of sample collection. Phylogenetic analysis of major capsid protein 2 (VP2) and VP3 coding region showed high similarity with B19V genotype 1.

CONCLUSIONS

Our results reveal the spread of B19V genotype 1 in Tefé. Moreover, our results emphasize the significance of laboratorial differential diagnosis using molecular techniques in patients with acute febrile, and thereby aid the health surveillance system in improving patient care even in the remote areas of Amazon.

摘要

简介

人细小病毒 B19(B19V)是一种常见的病原体,感染后可引起从良性自限性出疹性疾病和其他类似病变到胎儿死亡等多种临床病症。

方法

我们收集了 341 份疑似登革热患者在特菲地区医院就诊的症状出现后第 1 至第 4 天的血清样本。最初,通过血涂片检查对疟疾进行了筛查,阴性样本被送往位于马瑙斯的热带医学基金会(FMT-HVD)进行登革热检测,采用半巢式多重 PCR。此外,我们对 44 份疟疾和登革热阴性的儿童样本进行了 B19V DNA 的巢式 PCR 检测。阳性样本与整个公共非冗余核苷酸数据库进行 BLAST 分析,并通过邻接法聚类方法进行系统发育分析进行基因分型。

结果

发现 8 份样本(18.2%)PCR 阳性。患者报告的最常见症状为发热、头痛、眼痛和/或肌肉疼痛,在采集样本时均未诊断出皮疹。主要衣壳蛋白 2(VP2)和 VP3 编码区的系统发育分析显示与 B19V 基因型 1高度相似。

结论

我们的结果表明 B19V 基因型 1 在特菲的传播。此外,我们的结果强调了使用分子技术进行实验室差异诊断的重要性,尤其是在急性发热的患者中,这有助于卫生监测系统改善患者护理,即使在亚马逊地区的偏远地区也是如此。

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