摘要
於正常使康的成年水痘患者，併姿水痘性肺炎並不常見，其發生率約為百分之五或是更低。若未經治療的病例約有百分之十的死亡率。於急診室若有高度之警覺性經由典型的皮膚病灶及胸部X光片即可及早臨床診斷水痘性肺炎。早期使用抗病毒製劑，Acyclovir，可避免肺部病灶之思化及呼吸衰竭之併發症。本病例為一35歲健康良好之中年男性，因軀幹皮膚水泡疹合併有發燒已有三天而至急診室就診，經詢問病史發現患者亦有咳嗽及微量疚液之呼吸道的症狀。患者之胸部X光片顯示瀰漫性細微結節狀病灶散佈於整個肺部，肺尖部則較為輕微。經臨床診斷為水痘性肺炎徒，Acyclovir 500mg(10mg/Kg)、每八小時靜脈注射一次於患者，在往復追蹤之胸部 x 光片顯示肺部病灶已完全吸收而與殘留之病灶。在使用Acyclovir七天，患者呼吸道症狀已顯著改善彼，出院返家。
並列摘要
Varicella pneumonia is a rare but serious manifestation of disseminated varicella zoster virus infection in the immunocompetent adult. If left untreated, fatal respiratory failure may arise in approximately 10% of these varicella pneumonia patients. The clinical diagnosis can be made promptly from the classic varicelliform skin rash and the typical pattern of the chest roentgenogram in the emergency room. Early, aggressive administration of acyclovir, an antiviral agent, is crucial to prevent the progression of lung injury. We report a 35 year-old male who visited the emergency room for progressive vesicular eruptions over the body and high fever for 3 days. A chest roentgenogram revealed diffuse, ill defined, tiny nodular infiltrates in both lung fields with apical sparing. Acyclovir, 500mg, was administered parenterally every 8 hours. Follow-up chest roentgenograms showed nearly complete resolution of the lung lesions. The patient was discharged 7 days after admission in a stable condition.
延伸閱讀
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