parainfluenza
Introduction
Introduction to parainfluenza Light upper respiratory tract infections are often caused in adults, while children under 5 years of age are mainly lower respiratory tract infections with the highest incidence. basic knowledge The proportion of illness: 0.0085% Susceptible people: more common in children under 5 years old Mode of infection: respiratory infection Complications: pneumonia
Cause
Parainfluenza cause
(1) Causes of the disease
The parainfluenza virus is a paramyxovirus genus, spherical, 125-250 nm in diameter, enveloped, single-stranded RNA, and has 4 types. Type 4 is further divided into two subtypes, A and B, in primary monkey kidney cells or The virus can be isolated from primary human embryonic kidney cells. This virus is also known as the Sendai virus because it is isolated from a child died in Sendai, Japan.
(two) pathogenesis
When the respiratory virus invades the ciliated epithelial cells on the surface of human respiratory tract, it replicates and spreads in it and directly causes damage to the infected cells, causing local lesions or systemic toxic symptoms. The tissue damage caused by some viruses may be caused by the body's immune response. Mediated, such as respiratory syncytial virus, the direct damage to the airway epithelial cells of the respiratory tract is the lightest, but can cause serious respiratory diseases in infants and young children; the most prone to age is the highest level of maternal antibody; the natural infection after vaccination The severity of the disease suggests that the pathogenesis may be related to the immune response. The pathological changes of respiratory virus infection include nasal, pharyngeal, laryngeal mucosal congestion, edema, exudation and monocyte infiltration, and some cells may undergo degeneration, necrosis, and shedding. Inclusion bodies are visible in the cytoplasm or nucleus of epithelial cells. The degree of lesions is related to the type, type and location of the virus. After a few days, the epithelial cells can regenerate and return to normal. If the lesion involves the bronchioles, epithelial cell necrosis and exfoliation may occur. The bronchiole wall has extensive mononuclear cell infiltration, fibrin, cell debris and viscous Mucus can block the lumen and cause atelectasis, emphysema, viral pneumonia initially manifested as progressive reduction of cilia, epithelial vacuolization, epithelial cell degeneration, alveolar necrosis, collapse, alveolar wall visible Necrosis and thickening, interstitial edema and monocytes, lymphocytic infiltration, and bacterial infection, mucosal hyperemia, neutrophil infiltration and mucopurulent secretions can be seen. In severe cases, lung abscess, sepsis and multiple Suppurative changes in organs.
Prevention
Parainfluenza prevention
1. Always keep air circulation and pay attention to room disinfection, try to avoid contact with pollutants and patients.
2. Multi-valent and monovalent inactivated vaccines can produce serum antibodies, and the attenuated live vaccine spray immunity is being observed.
Prevention and treatment of influenza:
1. Banlangen, Daqingye, Guanzhong 30g each, decoction on behalf of tea.
2. Summer virus virus combination: 12 grams of medlar leaves, 15 grams of comfrey, 6 grams of citron, 10 grams of musk, peland, magnolia, each dose of water, soak for half an hour, simmer for 10 minutes Filter and take the liquid for use, 1 dose per day, 2 times warm clothes. Suitable for summer heat virus.
Landi soup: 50 grams of Banlangen, 50 grams of raw land, 20 grams of inch winter, 20 grams of Zhimu, 20 grams of mulberry leaves, 15 grams of platycodon, 15 grams of medlar, 1 dose per day, 2 times of water decoction, 2-3 times Warm clothes, even served 3 times, for yin deficiency virus.
Complication
Parainfluenza complications Complications pneumonia
Concurrent pneumonia. The condition of the parainfluenza is further aggravated, or the condition is aggravated after the recovery period of the flu, and there is high fever, severe cough, purulent sputum, difficulty in breathing, wet rales in the lungs, and signs of lung consolidation. The total number of peripheral white blood cells and neutrophils increased significantly, mainly by Streptococcus pneumoniae, Staphylococcus aureus, especially methicillin-resistant Staphylococcus aureus, Streptococcus pneumoniae or Haemophilus influenzae.
Symptom
Parainfluenza symptoms Common symptoms Sputum cough, runny nose, dog-like cough, sore throat, fever, hoarseness
The incubation period is 3 to 6 days.
1. The primary infection is more acute, most of them have fever, runny nose, sore throat. Types 1 and 2 are characterized by croup. There are canine-like spastic coughs, hoarseness and varying degrees of difficulty in breathing, and some are complicated. Inspiratory wheezing, signs of chest wall depression, X-ray see the characteristic "steeple sign" under the glottic stenosis, can be life-threatening, type 3 in 1 year old infants with bronchiolitis and pneumonia, 1 ~ 3 The age is croup, the older child is bronchitis, the fever often takes about 4 days at the beginning of the disease, and the child has about 30% of the lower respiratory tract lesions. In children with severe combined immunodeficiency disease, the incidence of this type is very high, and giant cells can be formed. Pneumonia (giant cell pneumonia), type 4 is a mild cold or asymptomatic, does not have fever, usually does not seek medical treatment, parainfluenza can induce asthma and increase asthma, but also complicated by mumps, otitis media.
2. Reinfection is more common in school-age children and adults. It can be repeatedly infected within a few months or years of initial infection. It is generally a mild common cold, and often does not seek medical treatment. Older people can cause pneumonia.
Examine
Influenza check
The total number of white blood cells is normal or slightly reduced, lymphocytes are relatively high, and erythrocyte sedimentation rate is normal.
Nasopharyngeal swab virus is isolated, and the general radiograph is seen in the characteristic "steeple sign" of the subglottic stenosis.
Diagnosis
Parainfluenza diagnosis
According to epidemiological and clinical data, diagnosis depends on virus isolation and serological examination.
1. Virus isolation Early as a throat swab to isolate the virus, the primary monkey kidney cells or primary human embryonic kidney cells have a high positive rate of isolation, usually cultured for 10 days (re-infected patients need 15 to 20 days, type 4 virus grows slowly, It takes 20 days or more to confirm the presence of the virus by the guinea pig erythrocyte adsorption inhibition test.
2. Serological examination Take the sera from the beginning of the disease and 3 to 4 weeks after the disease as a complement-binding test. The hemagglutination inhibition or neutralization test measures the antibody titer. If it is 4 times higher, it has diagnostic significance.
It should be differentiated from the common cold and light flu.
