Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea.
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea.
Mil Med Res. 2020 Feb 21;7(1):6. doi: 10.1186/s40779-020-00235-x.
In 2014, an outbreak of adenoviral pneumonia occurred in the Korean military training center. However, there are limited data on the characteristics of the fever and its response to antipyretic therapy in immunocompetent adults with adenovirus-positive community-acquired pneumonia (CAP).
The medical records of the patients who were admitted to the Armed Forces Chuncheon Hospital for the treatment of CAP between January 2014 and December 2016 were retrospectively analyzed. The patients were divided into three groups, namely, the adenovirus-positive (Adv) group, the adenovirus-negative (Non-Adv) group and the unknown pathogen group, according to the results of a polymerase chain reaction (PCR) test and sputum culture used to measure adenovirus and other bacteria or viruses in respiratory specimens. We evaluated and compared the demographics, clinicolaboratory findings and radiological findings upon admission between the two groups.
Out of the 251 military personnel with CAP during the study periods, 67 were classified into the Adv group, while 134 were classified into the Non-Adv group and 50 were classified into the unknown pathogen group. The patients in the Adv group had a longer duration of fever after admission (3.2 ± 1.6 vs. 1.9 ± 1.2 vs. 2.2 ± 1.5 days, P = 0.018) and symptom onset (5.8 ± 2.2 vs. 3.9 ± 2.5 vs. 3.7 ± 2.0 days, P = 0.006) than patients in the Non-Adv and unknown pathogen groups, respectively. The patients in the Adv group had a higher mean temperature at admission (37.8 ± 0.3 vs. 37.3 ± 0.3 vs. 37.3 ± 0.3, P = 0.005), and more patients were observed over 40 and 39 to 40(14.9% vs. 2.2% vs. 4.0%, 35.8% vs. 3.7% vs. 6.0%, P < 0.001) than those in the Non-Adv and unknown pathogen groups, respectively. The Adv group more commonly had no response or exhibited adverse events after antipyretic treatment compared to the Non-Adv group (17.9% vs. 1.5%, 35.0% vs. 4.3%, P < 0.001, P = 0.05, respectively). In addition, the time from admission to overall clinical stabilization was significantly longer in the patients in the Adv group than in those in the Non-Adv group (4.3 ± 2.8 vs. 2.9 ± 1.8 days, P = 0.034, respectively). Furthermore, no significant difference in the length of hospital stay was observed between the two groups, and no patient died in either group.
In this study, Adv-positive CAP in immunocompetent military personnel patients had distinct fever characteristics and responses to antipyretic treatment.
2014 年，韩国军事训练中心发生腺病毒肺炎疫情。然而，目前关于免疫功能正常的成人腺病毒阳性社区获得性肺炎（CAP）患者发热特征及其对退热治疗反应的数据有限。
回顾性分析 2014 年 1 月至 2016 年 12 月期间因 CAP 入住韩国武装部队春川医院的患者的病历。根据聚合酶链反应（PCR）检测和痰培养结果，将患者分为腺病毒阳性（Adv）组、腺病毒阴性（Non-Adv）组和未知病原体组，以测量呼吸道标本中的腺病毒和其他细菌或病毒。我们评估并比较了两组患者入院时的人口统计学、临床实验室和影像学结果。
在研究期间，251 名 CAP 军人中，67 名被归入 Adv 组，134 名被归入 Non-Adv 组，50 名被归入未知病原体组。Adv 组患者的发热时间（3.2±1.6 天比 1.9±1.2 天比 2.2±1.5 天，P=0.018）和症状起始时间（5.8±2.2 天比 3.9±2.5 天比 3.7±2.0 天，P=0.006）均长于 Non-Adv 组和未知病原体组。Adv 组患者的入院平均体温（37.8±0.3℃比 37.3±0.3℃比 37.3±0.3℃，P=0.005）较高，入院时体温超过 40℃和 39-40℃的患者比例也高于 Non-Adv 组（14.9%比 2.2%比 4.0%，35.8%比 3.7%比 6.0%，P<0.001）。与 Non-Adv 组相比，Adv 组患者退热治疗后无反应或出现不良反应的比例更高（17.9%比 1.5%，35.0%比 4.3%，P<0.001，P=0.05）。此外，Adv 组患者从入院到整体临床稳定的时间明显长于 Non-Adv 组（4.3±2.8 天比 2.9±1.8 天，P=0.034）。此外，两组患者的住院时间无显著差异，且两组均无患者死亡。
在这项研究中，免疫功能正常的军人中腺病毒阳性 CAP 具有明显的发热特征和对退热治疗的反应。
