McMillan J A, Weiner L B, Higgins A M, Lamparella V J
Department of Pediatrics, SUNY Health Science Center, Syracuse.
Pediatr Infect Dis J. 1993 Apr;12(4):280-4. doi: 10.1097/00006454-199304000-00004.
During a 16-month period patients who presented to the Syracuse University Health Center with upper respiratory complaints had throat swabs obtained for viral, streptococcal and Mycoplasma pneumoniae cultures. Thirty-five of 613 patients (5.7%) had herpes simplex virus (HSV) isolated. All but 2 of the HSV isolates were found to be type 1 by immunofluorescent staining. Two HSV-positive patients also grew Group A Streptococcus, one grew M. pneumoniae and three had serum heterophile antibody tests that were positive. On physical examination 25 of the 35 HSV-positive patients had pharyngeal erythema and 14 had pharyngeal exudate. Twelve of these patients had vesicular lesions of the lips, throat or gums associated with their other symptoms. For 29 of the 35 HSV-positive students the primary diagnosis assigned was pharyngitis, for 2 the diagnosis was stomatitis and the remainder were assigned a primary diagnosis of upper respiratory infection, pneumonia, bronchitis or dental infection. Thirty-two of the 35 HSV-positive patients were treated with oral antibiotics and 7 were treated with oral or topical acyclovir. During the same 16-month period 89 (6.9%) of 1297 students presenting with sore throat were culture-positive for influenza A or B, 30 (2.3%) of 1283 were culture-positive for M. pneumoniae and 169 (2.8%) of the 6016 cultured for Group A Streptococcus were positive. Serum was tested for heterophile antibody in 2438 students, and 257 (10.5%) were positive. Herpes simplex virus is associated with pharyngeal symptoms in college students, and herpes simplex pharyngitis cannot easily be distinguished clinically from other causes of acute pharyngitis in this age group.
在16个月的时间里，到雪城大学健康中心就诊、有上呼吸道不适症状的患者接受了咽喉拭子采样，用于病毒、链球菌和肺炎支原体培养。613名患者中有35名（5.7%）分离出单纯疱疹病毒（HSV）。通过免疫荧光染色发现，除2株外，所有HSV分离株均为1型。2名HSV阳性患者还培养出A组链球菌，1名培养出肺炎支原体，3名血清嗜异性抗体检测呈阳性。体格检查发现，35名HSV阳性患者中有25名咽部红斑，14名有咽部渗出物。其中12名患者嘴唇、咽喉或牙龈有水泡性病变，并伴有其他症状。35名HSV阳性学生中，29名的初步诊断为咽炎，2名诊断为口腔炎，其余患者的初步诊断为上呼吸道感染、肺炎、支气管炎或牙科感染。35名HSV阳性患者中有32名接受了口服抗生素治疗，7名接受了口服或局部阿昔洛韦治疗。在同一16个月期间，1297名出现咽喉痛的学生中有89名（6.9%）甲型或乙型流感培养呈阳性，1283名中有30名（2.3%）肺炎支原体培养呈阳性，6016名培养A组链球菌的患者中有169名（2.8%）呈阳性。对2438名学生进行了血清嗜异性抗体检测，其中257名（10.5%）呈阳性。单纯疱疹病毒与大学生的咽部症状有关，在这个年龄组中，单纯疱疹性咽炎在临床上不易与急性咽炎的其他病因区分开来。
