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合并感染临床病例:一名儿童的登革热和呼吸道支原体感染

Clinical case of co-infection: Dengue fever and respiratory mycoplasmosis in a child.

作者信息

Preobrazhenskaia D V, Melekhina E V, Ponezheva Zh B

机构信息

Central RI [Research Institute] of Epidemiology, Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor), Moscow, Russia.

出版信息

Respir Med Case Rep. 2024 Dec 26;53:102158. doi: 10.1016/j.rmcr.2024.102158. eCollection 2025.

DOI:10.1016/j.rmcr.2024.102158
PMID:39850109
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11754817/
Abstract

According to WHO, dengue fever (DF) is currently endemic to more than 100 countries in various regions of Africa, America, and Asia; outbreaks have been reported in Europe. In the Russian Federation, there is a much smaller proportion of children among those infected due to the imported nature of the infection. We described a clinical case of imported dengue fever in an adolescent girl in Moscow after a 5-day vacation. Despite the fact that during the examination at the hospital in the Maldives, DENV arbovirus antigen was isolated in the blood by immunochromatographic rapid test, the course of the disease had a number of symptoms that did not conform to the classical course of the disease: catarrhal symptoms, cough, elevated C-reactive protein, and radiographic evidences of right-sided maxillary sinusitis. No improvement in the condition was observed despite the therapy administered. Additional examination confirmed an active infection caused by . After correction of etiotropic and pathogenetic therapy, the patient was discharged with recovery on day 10 of the disease. After 4 years since the start of the pandemic, an increase in infectious morbidity, particularly DF, has been observed. The proportion of co-infections is increasing. Co-infection of DF and respiratory mycoplasmosis in children may occur masked as an acute respiratory viral infection (ARVI): with intensification of catarrhal and intoxication syndromes and atypical changes in laboratory parameters. All that complicates clinical and laboratory diagnosis and leads to incorrect administration of starting etiotropic therapy.

摘要

根据世界卫生组织的数据,登革热目前在非洲、美洲和亚洲各地区的100多个国家呈地方流行;欧洲也报告有疫情爆发。在俄罗斯联邦,由于感染具有输入性,感染者中儿童的比例要小得多。我们描述了一名莫斯科青少年女孩在5天假期后感染输入性登革热的临床病例。尽管在马尔代夫医院检查期间,通过免疫层析快速检测在血液中分离出登革病毒抗原,但该疾病的病程有一些不符合典型病程的症状:卡他症状、咳嗽、C反应蛋白升高以及右侧上颌窦炎的影像学证据。尽管进行了治疗,病情仍未见改善。进一步检查证实为由……引起的活动性感染。在纠正了病因治疗和发病机制治疗后,患者在疾病第10天康复出院。自疫情开始4年来,观察到感染性发病率上升,尤其是登革热。合并感染的比例在增加。儿童登革热与呼吸道支原体感染可能以急性呼吸道病毒感染(ARVI)的形式隐匿发生:伴有卡他和中毒综合征加重以及实验室参数的非典型变化。所有这些都使临床和实验室诊断复杂化,并导致起始病因治疗的错误应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d219/11754817/4e26aa52c52d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d219/11754817/78af1c0f9cc3/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d219/11754817/4e26aa52c52d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d219/11754817/78af1c0f9cc3/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d219/11754817/4e26aa52c52d/gr2.jpg

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本文引用的文献

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Parents' Level of Knowledge, Attitudes, and Practices and Associated Sociodemographic Factors Regarding Dengue Infection in Children.父母关于儿童登革热感染的知识水平、态度和行为以及相关社会人口学因素
Cureus. 2023 Nov 6;15(11):e48357. doi: 10.7759/cureus.48357. eCollection 2023 Nov.
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Neurological Manifestations of Perinatal Dengue.围产期登革热的神经学表现
Newborn (Clarksville). 2023;2(2):158-172. doi: 10.5005/jp-journals-11002-0066. Epub 2023 May 7.
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Direct and indirect effects of age on dengue severity: The mediating role of secondary infection.
年龄对登革热严重程度的直接和间接影响:二次感染的中介作用。
PLoS Negl Trop Dis. 2023 Aug 9;17(8):e0011537. doi: 10.1371/journal.pntd.0011537. eCollection 2023 Aug.
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Dengue Fever in a Neonate: A Case Report.新生儿登革热:病例报告。
JNMA J Nepal Med Assoc. 2023 Mar 1;61(259):287-289. doi: 10.31729/jnma.8099.
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[Characteristics of imported cases of Dengue fever and hemorrhagic Dengue fever in 2009-2019].[2009 - 2019年输入性登革热和登革出血热病例特征]
Vopr Virusol. 2022 Sep 12;67(4):322-330. doi: 10.36233/0507-4088-126.