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[阿根廷汉坦病毒临床感染的回顾性检测]

[Retrospective detection of hantavirus clinical infections in Argentina].

作者信息

Nieves Parisi M D, Enria D A, Pini N C, Sabattini M S

机构信息

Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui, Pergamino, Buenos Aires.

出版信息

Medicina (B Aires). 1996;56(1):1-13.

PMID:8734923
Abstract

Hantavirus activity in rodents and human beings in Argentina has been known since the 1980's. In this study, we retrospectively investigated hantavirus infections among Argentine Hemorrhagic Fever (AHF) cases notified between 1987 and 1994, without virological confirmation. IgG and IgM antibodies to hantavirus were tested by ELISA. Among 1028 patients included in the study, we found 13 recent infections (1.26%) and 13 remote infections (1.26%). IgG antibodies determined in 745 healthy persons living in the same localities of recent infection cases, gave only one positive result (0.13%). Nine of the 13 recent infections had the clinical presentation of Hemorrhagic Fever with Renal Syndrome (HFRS) while the other four were in the form of Hantavirus Pulmonary Syndrome (HPS). We performed a clinical and epidemiological comparison between the nine patients with FHSR and two paired control groups: one with confirmed AHF and the other with Febrile Syndrome of Undetermined Etiology (FSUE), which were negative for hantavirus, Junin and LCM. There were no differences between clinical signs or symptoms. Nevertheless, normal or high leucocyte counts, with thrombocytopenia, hemoconcentration, high creatinine levels and proteinuria in HFRS cases resulted useful for differential diagnosis. These results showed the coexistence of Junin virus and hantaviruses in the endemic area of AHF, and indicate the importance of including the infection with these viruses in the differential diagnosis of hemorrhagic fevers and respiratory distress syndromes of unknown etiology. The clinical variability found could be related to the presence of more than one hantavirus serotype in our country.

摘要

自20世纪80年代以来,阿根廷啮齿动物和人类中的汉坦病毒活动已为人所知。在本研究中,我们回顾性调查了1987年至1994年期间报告的阿根廷出血热(AHF)病例中的汉坦病毒感染情况,这些病例未经病毒学确诊。通过酶联免疫吸附测定(ELISA)检测汉坦病毒的IgG和IgM抗体。在纳入研究的1028名患者中,我们发现13例近期感染(1.26%)和13例既往感染(1.26%)。在近期感染病例所在同一地区居住的745名健康人中检测到的IgG抗体,仅得到1例阳性结果(0.13%)。13例近期感染中有9例临床表现为肾综合征出血热(HFRS),另外4例为汉坦病毒肺综合征(HPS)。我们对9例HFRS患者与两个配对对照组进行了临床和流行病学比较:一组为确诊的AHF患者,另一组为病因未明的发热综合征(FSUE)患者,这两组患者的汉坦病毒、胡宁病毒和淋巴细胞脉络丛脑膜炎病毒检测均为阴性。临床体征或症状方面没有差异。然而,HFRS病例中白细胞计数正常或升高、伴有血小板减少、血液浓缩、肌酐水平升高和蛋白尿,这些结果有助于鉴别诊断。这些结果表明在AHF流行地区存在胡宁病毒和汉坦病毒共存的情况,并表明在病因不明的出血热和呼吸窘迫综合征的鉴别诊断中纳入这些病毒感染的重要性。所发现的临床变异性可能与我国存在不止一种汉坦病毒血清型有关。

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