其他表现
季节性流感可能很少表现为无发热的上呼吸道疾病,更像普通感冒,或者该病的呼吸道症状很少,主要表现为发热和肌痛。[2]Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza. Clin Infect Dis. 2019 Mar 5;68(6):e1-47.
https://academic.oup.com/cid/article/68/6/e1/5251935
http://www.ncbi.nlm.nih.gov/pubmed/30566567?tool=bestpractice.com
高风险人群患者(例如,患有慢性心脏或肺部疾病、糖尿病、肾脏疾病、血红蛋白病、免疫抑制、长期居住在养老院、年龄>50 岁或妊娠晚期)可能出现原发性病毒性肺炎或继发性细菌性肺炎。[3]Neuzil KM, Wright PF, Mitchel EF Jr, et al. The burden of influenza illness in children with asthma and other chronic medical conditions. J Pediatr. 2000 Dec;137(6):856-64.
http://www.ncbi.nlm.nih.gov/pubmed/11113844?tool=bestpractice.com
原发性病毒性肺炎的特征是伴有呼吸困难或其他呼吸窘迫的持续发热或发热病程加重。[4]Martin CM, Kunin CM, Gottlieb LS, et al. Asian influenza A in Boston, 1957-1958. Arch Intern Med. 1959 Apr;103(4):515-31.
http://www.ncbi.nlm.nih.gov/pubmed/13636470?tool=bestpractice.com
如果症状初步改善后出现发热复发伴咳痰和气短,应怀疑继发性细菌性肺炎。胸部 X 线检查出现肺部浸润可证实诊断。