Avery R K, Longworth D L
Department of Infectious Diseases, Cleveland Clinic Foundation, 1 Clinic Center, OH 44195, USA.
Semin Thorac Cardiovasc Surg. 1995 Apr;7(2):88-94.
Viral respiratory infections are uncommon causes of pulmonary infiltrates in immunocompetent patients who undergo cardiothoracic surgery. In winter months, however, influenza can be acquired in the community preoperatively or in the hospital setting. The recognition of influenza cases is essential to prevent nosocomial transmission. Respiratory syncytial virus is also an important pulmonary pathogen in pediatric patients who undergo cardiothoracic surgery and may produce serious disease in children with underlying pulmonary or congenital heart disease. Viral infections of the respiratory tract are important causes of morbidity and mortality in heart and lung transplant recipients, especially cytomegalovirus (CMV). Other herpes viruses such as varicella zoster virus and herpes simplex virus may also occasionally involve the lung. Epstein-Barr virus has been incriminated in the pathogenesis of post-transplant lymphoproliferative disease, an uncommon but severe complication of transplantation. Except for Epstein-Barr virus, effective therapy exists for CMV and the other herpes viruses. Prophylaxis with ganciclovir is effective in preventing serious CMV infections in seropositive heart transplant recipients. However, better strategies are needed to prevent primary CMV infection in these patients.
在接受心胸外科手术的免疫功能正常患者中，病毒性呼吸道感染是肺部浸润的罕见病因。然而，在冬季，流感可在术前于社区或医院环境中感染。识别流感病例对于预防医院内传播至关重要。呼吸道合胞病毒也是接受心胸外科手术的儿科患者的重要肺部病原体，可能在患有潜在肺部疾病或先天性心脏病的儿童中引发严重疾病。呼吸道病毒感染是心肺移植受者发病和死亡的重要原因，尤其是巨细胞病毒（CMV）。其他疱疹病毒，如水痘带状疱疹病毒和单纯疱疹病毒，也可能偶尔累及肺部。 Epstein-Barr病毒与移植后淋巴细胞增生性疾病的发病机制有关，这是一种罕见但严重的移植并发症。除了Epstein-Barr病毒外，针对CMV和其他疱疹病毒都有有效的治疗方法。用更昔洛韦进行预防可有效预防血清反应阳性的心脏移植受者发生严重的CMV感染。然而，需要更好地预防这些患者的原发性CMV感染。
