Hubbell C, Dominguez R, Kohl S
Department of Pediatrics, University of Texas Medical School, Houston.
Rev Infect Dis. 1988 Mar-Apr;10(2):431-8. doi: 10.1093/clinids/10.2.431.
Four new cases of neonatal herpes pneumonia and five cases from the literature were assessed. Clinical presentations, laboratory abnormalities, and radiographic features were analyzed in an effort to establish helpful criteria for early institution of antiviral therapy. Any neonate who develops respiratory distress between the third and 14th days of life and has a chest radiograph that reveals prominent hilar with a central interstitial infiltrate is at high risk for herpes pneumonia. Antiviral therapy pending antigen detection and culture results should be strongly considered in any such patient when the etiology of pneumonitis is unknown and any of the following is found: (1) thrombocytopenia; (2) evidence of disseminated intravascular coagulation; (3) elevated values in liver function tests; (4) a positive result in a rapid screening test for herpes simplex virus; (5) lymphocytic pleocytosis of the cerebrospinal fluid; (6) development of vesicular skin lesions; or (7) further deterioration in clinical status during treatment with antibiotics.
评估了4例新生儿疱疹性肺炎新病例以及文献报道的5例病例。分析了临床表现、实验室异常及影像学特征，以确立有助于早期应用抗病毒治疗的标准。任何在出生后第3至14天出现呼吸窘迫且胸部X线片显示肺门突出伴中央间质浸润的新生儿，患疱疹性肺炎的风险很高。当肺炎病因不明且出现以下任何一种情况时，对于任何此类患者，在等待抗原检测和培养结果期间应强烈考虑进行抗病毒治疗：（1）血小板减少；（2）弥散性血管内凝血的证据；（3）肝功能检查值升高；（4）单纯疱疹病毒快速筛查试验阳性；（5）脑脊液淋巴细胞增多；（6）出现水疱性皮肤损害；或（7）抗生素治疗期间临床状况进一步恶化。
