measles virus pneumonia
Introduction
Introduction to measles virus pneumonia Measles virus pneumonia is the most common complication of measles, especially in infants and children with low immunity, mostly in the early stages of the disease. In children with measles, the symptoms of measles are obviously aggravated, the high fever continues to retreat, the cough is intensified, the breathing is short, the nose is fanned, the hair is sputum, the lungs can smell dry and wet, most of them follow the measles fever, the rash retreats and the pneumonia also Gradually dissipated. However, malnutrition is caused by malnutrition and weak immunity. The disease often persists. basic knowledge Sickness ratio: 0.001%-0.025% Susceptible people: no special people Mode of infection: respiratory transmission Complications: bacterial pneumonia
Cause
Measles virus pneumonia
(1) Causes of the disease
Measles is an acute infectious disease caused by measles virus. The most common complication is measles pneumonia. Measles virus can invade the entire respiratory mucosa and produce pneumonia. It can occur in the pre-rash and rash. In the rash period, children with low immune function often have no rash, and are prone to giant cell pneumonia. Due to extensive damage of the respiratory mucosa, bacterial infection is often accompanied by rash or rash, which occurs mostly in malnourished and frail children. The pathogenic bacteria are common with Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae. Among them, Staphylococcus aureus is particularly common, and the condition is more serious. A small number of children can still be infected with adenovirus, and measles is accompanied by bacteria. Sexual infections and adenovirus infections are more serious, often leading to death from measles pneumonia.
(two) pathogenesis
The main pathological change of measles is the formation of multinucleated giant cells by extensive cell fusion. The pathological manifestations of measles virus pneumonia are acute inflammation of the epithelial cells of the respiratory tract including bronchi and bronchioles, mucosal edema, congestion, necrosis can form ulcers with cilia shedding, interstitial Mononuclear cells and multinucleated giant cells form, lesions involve the bronchioles, lymphocyte-based mononuclear cells infiltrating interstitial pneumonia, intrapulmonary lesions can be fused, invading the reticuloendothelial system, causing lymphadenopathy, respiratory tract Epithelial multinucleated giant cells appear in the alveolar wall, and the nucleus and cytoplasm contain eosinophilic inclusion bodies called giant cell pneumonia. The alveoli are filled with shed denatured epithelial cells, multinucleated cells and monocytes, and the alveolar wall has a transparent membrane and bronchial secretion. Lack of exfoliated cells can cause partial obstruction of the bronchus and local emphysema and complete obstruction of the bullae can occur atelectasis, accompanied by bacterial infections, pathological changes of bronchial pneumonia, sometimes with empyema or pus, and prolonged lesions Unhealed can produce bronchiectasis.
Prevention
Measles virus pneumonia prevention
Measles has been rare in China since the widespread inoculation of live attenuated measles vaccine. Measles pneumonia is rare. Due to the serious condition of measles pneumonia, especially the secondary bacterial infection and adenovirus infection, the mortality rate is high. Be alert to the existence of these comorbidities in order to diagnose and deal with them as soon as possible.
Complication
Measles virus pneumonia complications Complications bacterial pneumonia
Often complicated by bacterial pneumonia.
Symptom
Measles virus pneumonia symptoms Common symptoms Myalgia dry cough, abdominal pain, dryness, high fever, no dehumidification, snoring, shortness of breath, nose, fan, hair, lung, purulent infection
Pneumonia is the most common complication of measles. It is caused by low immunity in infants and young children. It occurs mostly in the early stage of the disease. The respiratory symptoms of measles are obviously worsened when pneumonia occurs. The high fever continues to retreat, the cough is intensified, the breathing is short, and the nose flaps. , cyanosis, lungs can smell and dry and wet sputum with measles fever, rash retreat and pneumonia also gradually dissipated, but malnutrition, weak immune system, giant cell pneumonia, the disease often prolonged, rash During the period of rash and rash, the body temperature does not retreat, or fever after fever, fever, respiratory symptoms aggravated, white blood cells increased, suggesting that bacterial pneumonia may be complicated, and there is more chance of empyema. In the past, measles inactivated vaccine was born. The antibody level is not high, and a few years later, it can cause measles, which can produce atypical measles syndrome (AMS). Occasionally, it is also seen in patients who have received a live attenuated vaccine. The symptoms are atypical, and the symptoms of poisoning are often heavy and the symptoms of catarrhal are few. High fever, headache, dry cough, abdominal pain, myalgia and other symptoms, mucosal plaques are rarely seen, rashes first in the limbs, and then spread to the heart, often complicated by pneumonia, can produce chest The effusion and lung lesions can be absorbed after several months. The pathogenesis of atypical measles syndrome is still unclear. It may be related to the hypersensitivity reaction of measles virus to patients with partial immunity. The measles vaccine was replaced by a live attenuated measles vaccine, so atypical measles syndrome is rare.
Examine
Measles virus pneumonia check
1. Nasopharyngeal secretions, sputum bacterial smears to check sputum smear.
2. Hemagglutination inhibition in the acute phase and recovery phase, enzyme-linked immunosorbent assay for detection of measles IgG, measles complement test.
3. Antibody capture enzyme-linked immunosorbent assay for detection of measles IgM, with high sensitivity and specificity, and has early diagnostic value.
4. Chest X-ray examination, measles virus pneumonia showed diffuse bronchioles and interstitial inflammation changes, inflammatory infiltration of lung texture bacterial infection is often bronchial pneumonia distributed in the lung segment, mostly located in one or both lungs Lower leaves.
Diagnosis
Diagnosis and identification of measles virus pneumonia
diagnosis
According to the characteristic oral mucosal plaque and rash, combined with epidemiological patients with 2 to 3 weeks of history of measles exposure and chest X-ray pneumonia can make a diagnosis, nasopharyngeal secretions, sputum smear for Rayleigh staining Observed multinucleated giant cells, or detected measles virus fluorescent antigen, or measles virus isolated in tissue culture can determine early diagnosis, hemagglutination inhibition in acute phase and recovery phase, enzyme-linked immunosorbent assay for measles IgG, measles complement Combined with the test, the specific antibody is increased by 4 times or more, which is helpful for diagnosis. The antibody capture enzyme-linked immunosorbent assay (ELISA) detects measles IgM, and has high sensitivity and specificity, and has early diagnostic value.
Differential diagnosis
Should be identified with other viral, rash diseases, such as rubella, parvovirus, enterovirus and so on.
