Parashar Umesh D, Glass Roger I
Viral Gastroenteritis Section, Respiratory and Enteric Viruses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Perspect Med Virol. 2003;9:9-21. doi: 10.1016/S0168-7069(03)09002-5. Epub 2004 Sep 14.
This chapter discusses the causative viral agents, pathophysiology, and immunology of gastroenteritis. Acute gastroenteritis is among the most common illnesses of humans and is caused by a variety of agents, including bacteria, viruses, parasites, toxins, and chemicals. The clinical spectrum ranges from asymptomatic or mild infection to severe dehydrating illness with a fatal outcome; the latter occurs primarily in young children and in the elderly. The chapter concludes with a discussion on the prevention and treatment of gastroenteritis. For the prevention of epidemic viral gastroenteritis, efforts need to be focused on caliciviruses. No specific antiviral therapy is recommended for childhood viral gastroenteritis, emphasizing the importance of distinguishing it from the selected forms of bacterial and parasitic gastroenteritis that require treatment. Other than pertinent epidemiologic information, certain clinical features of illness may provide etiologic clues, but they are not highly discriminating. Standard therapy of viral enteric infections relies on maintenance of adequate hydration and electrolyte balance. Oral rehydration therapy (ORT) is the main treatment.
本章讨论了肠胃炎的致病病毒病原体、病理生理学和免疫学。急性肠胃炎是人类最常见的疾病之一,由多种因素引起,包括细菌、病毒、寄生虫、毒素和化学物质。临床症状范围从无症状或轻度感染到严重脱水疾病并导致死亡;后者主要发生在幼儿和老年人中。本章最后讨论了肠胃炎的预防和治疗。对于流行性病毒性肠胃炎的预防,需要重点关注杯状病毒。不建议对儿童病毒性肠胃炎进行特定的抗病毒治疗,这凸显了将其与需要治疗的特定形式的细菌性和寄生性肠胃炎区分开来的重要性。除了相关的流行病学信息外,疾病的某些临床特征可能提供病因线索,但它们的区分度不高。病毒性肠道感染的标准治疗依赖于维持充足的水合作用和电解质平衡。口服补液疗法(ORT)是主要治疗方法。