Adult respiratory distress syndrome as a cause of death in pneumococcal pneumonia. Report of ten cases.
Adult respiratory distress syndrome as a cause of death in pneumococcal pneumonia. Report of ten cases.
复制标题
成人呼吸窘迫综合征是肺炎球菌肺炎的死亡原因。
作者：
S. Fruchtman;M. Gombert;H. Lyons
肺炎球菌仍然是感染性肺炎的常见原因；然而，肺炎球菌病的死亡原因仍然不清楚。报告10例继发于肺炎球菌肺炎的成人呼吸窘迫综合征(ARDS)。这些患者年轻(中位年龄，33岁)和白细胞减少(中位白细胞计数，2.1细胞/立方毫米)，死亡率为50%(5名患者)。据推测，肺内白细胞的隔离可能在肺炎球菌病继发ARDS的发病机制中起作用。发现四种不同的肺炎球菌衣壳亚型(9V[68]；9A[33]；4；3)能够引起ARDS。目前可用的肺炎球菌疫苗不包含与ARDS相关的两种衣壳亚型。
The Pneumococcus continues to be a common cause of infectious pneumonia; however, the cause of death in pneumococcal disease remains obscure. Ten patients are described who developed the adult respiratory distress syndrome (ARDS) secondary to pneumococcal pneumonia. The patients are young (median age, 33 years) and leukopenic (median white blood cell count, 2.1 cells/cu mm) and have a mortality of 50 percent (five patients). It is postulated that pulmonary sequestration of leukocytes may play a role in the pathogenesis of ARDS secondary to pneumococcal disease. Four different pneumococcal capsular subtypes (9V [68]; 9A [33]; 4; 3) were found capable of causing ARDS. The currently available pneumococcal vaccine does not contain two of the capsular subtypes associated with ARDS.