Mulcahy D L, Hanlon M G, de Silva L M
J Infect. 1983 Jan;6(1):61-6. doi: 10.1016/s0163-4453(83)95671-2.
A spring-summer epidemic of echovirus II in New South Wales, Australia, is reported. The symptomatology was found to be age dependent. Neonates and young infants tended to have a severe 'septicaemic' illness. Older infants had a variety of clinical presentations: aseptic meningitis, febrile convulsions, upper respiratory tract infections, and acute enteritis. Children over the age of two in this study uniformly presented with symptoms suggestive of aseptic meningitis--confirmed by cerebrospinal (CSF) cytology in the majority of cases. The clinical presentation of an acute febrile illness in the young child may not allow for distinction between bacterial and viral infection. The importance of the recognition and confirmation of a viral aetiology relates to the subsequent management: i.e. antibiotics may be withheld, hospitalisation may be shortened, and a more favourable prognosis can be made. Certain epidemiological clues and laboratory studies are helpful in suggesting a viral aetiology, but a definitive diagnosis of enteroviral infection may only be readily achieved by virus isolation in tissue culture.
据报道,澳大利亚新南威尔士州出现了肠道病毒II型的春夏疫情。研究发现,症状表现与年龄有关。新生儿和幼儿往往患有严重的“败血症”疾病。年龄稍大的婴儿有多种临床表现:无菌性脑膜炎、热性惊厥、上呼吸道感染和急性肠炎。在本研究中,两岁以上的儿童均表现出提示无菌性脑膜炎的症状,大多数病例经脑脊液细胞学检查得以确诊。幼儿急性发热疾病的临床表现可能无法区分细菌感染和病毒感染。识别并确认病毒病因的重要性在于后续治疗:即可以不使用抗生素、缩短住院时间,并能有更好的预后。某些流行病学线索和实验室检查有助于提示病毒病因,但肠道病毒感染的确诊通常只能通过组织培养中的病毒分离来实现。