Dowell S F, Anderson L J, Gary H E, Erdman D D, Plouffe J F, File T M, Marston B J, Breiman R F
Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Infect Dis. 1996 Sep;174(3):456-62. doi: 10.1093/infdis/174.3.456.
Respiratory syncytial virus (RSV), the most important cause of lower respiratory disease in infants and young children, is rarely considered among the causes for community-acquired lower respiratory infection in adults. All noninstitutionalized adults hospitalized with community-acquired pneumonia in two Ohio counties were evaluated between December 1990 and May 1992. Fifty-three (4.4%) of 1195 adults admitted during the RSV seasons and 4 (1.0%) of 390 in the off-season had serologic evidence of RSV infection, making RSV one of the four most common pathogens identified. RSV-infected patients had clinical features (e.g., wheezing and rhonchi) that distinguished them from all non-RSV-infected patients and other features (e.g., nonelevated white blood cell counts) that distinguished them from those infected with bacterial or atypical agents. However, RSV infection was not diagnosed during hospitalization for any of the 57 RSV-infected patients. RSV should be considered in the differential diagnosis for adults hospitalized between November and April with community-acquired lower respiratory infection.
呼吸道合胞病毒(RSV)是婴幼儿下呼吸道疾病的最重要病因,但在成人社区获得性下呼吸道感染的病因中很少被考虑。1990年12月至1992年5月期间,对俄亥俄州两个县所有因社区获得性肺炎住院的非机构化成人进行了评估。在RSV流行季节入院的1195名成人中,有53名(4.4%),在非流行季节入院的390名成人中有4名(1.0%)有RSV感染的血清学证据,这使RSV成为已确定的四种最常见病原体之一。RSV感染患者具有一些临床特征(如喘息和干啰音),这些特征将他们与所有未感染RSV的患者区分开来,还有一些其他特征(如白细胞计数未升高)将他们与细菌或非典型病原体感染的患者区分开来。然而,这57名RSV感染患者在住院期间均未被诊断出RSV感染。对于11月至4月期间因社区获得性下呼吸道感染住院的成人,在鉴别诊断时应考虑RSV感染。