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. 2013 Sep 23;59(1):78–84. [Article in Portuguese] doi: 10.1590/S0104-42302013000100015

Atualização em pneumonia comunitária viral*

Update on viral community-acquired pneumonia

Ozéas Galeno da Rocha Neto 1,*, Ricardo Ferreira Leite 1, Bruno Guedes Baldi 1
PMCID: PMC7133596  PMID: 23440146

Resumo

A pneumonia de origem viral é uma causa prevalente de infecção respiratória em adultos imunocompetentes. Tem apresentação variada, ocasionando desde formas leves a quadros graves de insuficiência respiratória com necessidade de ventilação mecânica. Contudo, em nosso país, há poucos estudos a respeito da apresentação clínica e diagnóstico dessa infecção. Dessa forma, os autores do presente artigo têm por objetivo revisar os principais agentes virais causadores de pneumonia na comunidade e discutir as modalidades diagnósticas e terapêuticas disponíveis atualmente.

Palavras-chave: Pneumonia viral, Diagnóstico, Terapêutica

Footnotes

*

Trabalho realizado na Divisão de Pneumologia do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.

Referências

  • 1.Conterno L.O., Moraes F.Y.M., Silva Filho C.R. Implementation of community-acquired pneumonia guidelines at a public hospital in Brazil. J Bras Pneumol. 2011;37(2):152–159. doi: 10.1590/s1806-37132011000200004. [DOI] [PubMed] [Google Scholar]
  • 2.Donalisio M.R., Arca C.H., Madureira P.R. Clinical, epidemiological, and etiological profile of inpatients with community-acquired pneumonia at a general hospital in the Sumaré microregion of Brazil. J Bras Pneumol. 2011;37(2):200–208. doi: 10.1590/s1806-37132011000200010. [DOI] [PubMed] [Google Scholar]
  • 3.Figueiredo L.T.M. Viral pneumonia: epidemiological, clinical, pathophysiological and therapeutic aspects. J Bras Pneumol. 2009;35(9):899–906. doi: 10.1590/s1806-37132009000900012. [DOI] [PubMed] [Google Scholar]
  • 4.Jennings L.C., Anderson T.P., Beynon K.A., Chua A., Laing R.T., Werno A.M. Incidence and characteristics of viral community-acquired pneumonia in adults. Thorax. 2008;63(1):42–48. doi: 10.1136/thx.2006.075077. [DOI] [PubMed] [Google Scholar]
  • 5.Baldacci E.R. Que evidências temos para o diagnóstico diferencial inicial entre pneumonia bacteriana e viral? Rev Assoc Med Bras. 2003;49(3):225–243. [Google Scholar]
  • 6.Falsey A.R., McCann R.M., Hall W.J., Criddle M.M. Evaluation of four methods for the diagnosis of respiratory syncytial virus infection in older adults. J Am Geriatr Soc. 1996;44(1):71–73. doi: 10.1111/j.1532-5415.1996.tb05641.x. [DOI] [PubMed] [Google Scholar]
  • 7.Nascimento M.S., Souza A.V., Ferreira A.V.S., Rodrigues J.C., Abramovici S., Silva Filho L.V.F. High rate of viral identification and coinfections in infants with acute bronchiolitis. Clinics. 2010;65(11):1133–1137. doi: 10.1590/S1807-59322010001100014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Osiowy C. Direct detection of respiratory syncicial virus, parainfluenza virus, and adenovirus in clinical respiratory specimens by multiplex reverse transcription-PCR assay. J Clin Microbiol. 1998;36(11):3149–3154. doi: 10.1128/jcm.36.11.3149-3154.1998. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Johnstone J., Majumdar S.R., Fox J.D., Marrie T.J. Viral infection in adults hospitalized with community-acquired pneumonia: prevalence, pathogens and presentation. Chest. 2008;134(6):1141–1148. doi: 10.1378/chest.08-0888. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Angeles Marcos M., Camps M., Pumarola T., Antonio Martinez J., Martinez E., Mensa J. The role of viroses in the aetiology of community-acquired pneumonia in adults. Antivir Ther. 2006;11:351–359. [PubMed] [Google Scholar]
  • 11.Bacal F., Seguro L.F., Ogawa T., Mangini S., Fiorelli A., Bocchi E. Influenza A (H1N1) pneumonia in an immunossupressed patient after heart transplantation. Arq Bras Cardiol. 2009;93(6):e104–e106. [PubMed] [Google Scholar]
  • 12.Schout D., Hajjar L.A., Galas F.R.B.G., Uip D.E., Levin A.S.S., Caiaffa Filho H.H. Epidemiology of human infection with the novel virus influenza a (H1N1) in the Hospital das Clínicas, São Paulo Brazil – June-September 2009. Clinics. 2009;64(10):1025–1030. doi: 10.1590/S1807-59322009001000014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Toufen C., Jr., Costa E.L.V., Hirota A.S., Li H.Y., Amato M.B.P., Carvalho C.R.R. Follow-up after acute respiratory distress syndrome caused by influenza a (H1N1) virus infection. Clinics. 2011;66(6):933–937. doi: 10.1590/S1807-59322011000600002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Kallan A.J., Brunkard J., Moore Z., Budge P., Arnold K.E., Fosheim G. Staphylococcus aureus community-acquired pneumonia during the 2006 to 2007 influenza season. Ann Emerg Med. 2009;53(3):358–365. doi: 10.1016/j.annemergmed.2008.04.027. [DOI] [PubMed] [Google Scholar]
  • 15.Paiva M.B.S., Botoni F.A., Teixeira Junior A.L., Miranda A.S., Oliveira C.R.A., Jamila Abrahão J.O. The behavior and diagnostic utility of procalcitonin and five other inflammatory molecules in critically ill patients with respiratory distress and suspected 2009 influenza a H1N1 infection. Clinics. 2012;67(4):327–334. doi: 10.6061/clinics/2012(04)05. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Rodrigues R.S., Marchiori E., Bozza F.A., Pitrowsky M.T., Velasco E., Soares M. Chest computed tomography findings in severe influenza pneumonia occurring in neutropenic cancer patients. Clinics. 2012;67(4):313–318. doi: 10.6061/clinics/2012(04)03. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Capelozzi V.L., Parra E.R., Manoel Ximenes M., Bammann H., Barbas C.S.V., Duarte M.I.S. Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure. Clinics. 2010;65(12):1229–1237. doi: 10.1590/S1807-59322010001200003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Hayden F.G., Atmar R.L., Schilling M., Johnson C., Poretz D., Paar D. Use of the selective oral neuraminidase inhibitor oseltamivir to prevent influenza. N Eng J Med. 1999;341(18):1336–1343. doi: 10.1056/NEJM199910283411802. [DOI] [PubMed] [Google Scholar]
  • 19.Biatto J.F.P., Costa E.L.V., Pastore L., Kalla's E.G., Deheinzelin D., Schettino G. Prone position ventilation, recruitment maneuver and intravenous zanamivir in severe refractory hypoxemia caused by influenza A (H1N1) Clinics. 2010;65(11):1211–1213. doi: 10.1590/S1807-59322010001100026. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Queiróz D.A.O., Durigon E.L., Botosso V.F., Ejzemberg B., Vieira S.E., Mineo J.R. Immune response to respiratory syncytial virus in young brazilian children. Braz J Med Biol Res. 2002;35:1183–1193. doi: 10.1590/s0100-879x2002001000011. [DOI] [PubMed] [Google Scholar]
  • 21.Oliveira T.F.M., Freitas G.R.O., Ribeiro L.Z.G., Yokosawa J., Siqueira M.M., Portes S.A.R. Prevalence and clinical aspects of respiratory syncytial virus A and B groups in children seen at Hospital de Clínicas of Uberlândia, MG Brazil. Mem Inst Oswaldo Cruz. 2008;103(5):417–422. doi: 10.1590/s0074-02762008000500002. [DOI] [PubMed] [Google Scholar]
  • 22.Dowell S.F., Anderson J., Gary H.E., Erdman D.D., Pouffe J.F., File T.M. Respiratory syncytial virus is an important cause of community acquired lower respiratory infection among hospitalized adults. J Infect Dis. 1996;174(3):456–462. doi: 10.1093/infdis/174.3.456. [DOI] [PubMed] [Google Scholar]
  • 23.Vieira R.A., Diniz E.M.A., Ceccon M.E.J.R. Correlation between inflammatory mediators in the nasopharyngeal secretion and in the serum of children with lower respiratory tract infection caused by respiratory syncytial virus and disease severity. J Bras Pneumol. 2010;36(1):59–66. doi: 10.1590/s1806-37132010000100011. [DOI] [PubMed] [Google Scholar]
  • 24.Moscona A. Management of respiratory syncytial virus infections in the immunocompromised child. Pediatr Infect Dis J. 2000;19(3):253–254. doi: 10.1097/00006454-200003000-00017. [DOI] [PubMed] [Google Scholar]
  • 25.Hilleman M.R. Epidemiology of adenovirus respiratory infections in military recruit populations. Ann N Y Acad Sci. 1957;67(8):262–272. doi: 10.1111/j.1749-6632.1957.tb46049.x. [DOI] [PubMed] [Google Scholar]
  • 26.Castelli J.B., Siciliano R.F., Vieira R.D., Aiello V.D., Strabelli T.M.V. Fatal adenoviral necrotizing bronchiolitis case in a post-cardiac surgery intensive care unit. Braz J Infect Dis. 2011;15(3):285–287. doi: 10.1016/s1413-8670(11)70190-8. [DOI] [PubMed] [Google Scholar]
  • 27.Shields A.F., Hackman R.C., Fife K.H., Corey L., Meyers J.D. Adenovirus infections in patients undergoing bone-marrow transplantation. N Engl J Med. 1985;312(9):529–533. doi: 10.1056/NEJM198502283120901. [DOI] [PubMed] [Google Scholar]
  • 28.Bordigoni P., Carret A.S., Venard V., Witz F., Le Faou A. Treatment of adenovirus infections in patients undergoing allogenic hematopoietic stem cell transplantation. Clin Infect Dis. 2001;32(9):1290–1297. doi: 10.1086/319984. [DOI] [PubMed] [Google Scholar]
  • 29.Lewis V.A., Champlin R., Englund J., Couch R., Goodrich J.M., Rolston K. Respiratory disease due to parainfluenza virus in adult bone marrow transplant recipients. Clin Infect Dis. 1996;23(5):1033–1037. doi: 10.1093/clinids/23.5.1033. [DOI] [PubMed] [Google Scholar]
  • 30.Templeton K.E., Scheltinga S.A., van den Eeden W.C., Grafffelman A.W., van den Broek P.J., Claas E.C. Improved diagnosis of the etiology of community-acquired pneumonia with real-time polymerase chain reaction. Clin Inf Dis. 2005;41(3):345–351. doi: 10.1086/431588. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Chakrabati S., Colingham K.E., Holder K., Fegan C.D., Osman H., Milligan D.W. Pre-emptive oral ribavirin therapy of paramyxovirus infections after haematopoiestic stem cell transplantation: a pilot study. Bone Marrow Transplant. 2001;28(8):759–763. doi: 10.1038/sj.bmt.1703216. [DOI] [PubMed] [Google Scholar]
  • 32.Ruuskanen O., Lahti E., Jennings L.C., Murdoch D.R. Viral pneumonia. Lancet. 2011;377:1264–1275. doi: 10.1016/S0140-6736(10)61459-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33.van den Hoogen B.G., de Jong J.C., Groen J., Kuiken T., de Groot R., Fouchier R.A. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med. 2001;7(6):719–724. doi: 10.1038/89098. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34.Safdar A. Immune modulatory activity of ribavirin for serious human metapneumovirus disease: early I.V. therapy may improve outcomes in immunosuppressed SCT recipients. Bone Marrow Transplant. 2008;41(8):707–708. doi: 10.1038/bmt.2008.80. [DOI] [PubMed] [Google Scholar]
  • 35.Zhong N., Zheng N., Li Y., Poon, Xie Z.H., Chan K.H. Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong People's Republic of China, in February, 2003. Lancet. 2003;362:1353–1358. doi: 10.1016/S0140-6736(03)14630-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Tsang K., Ho P., Ooi G., Yee W.K., Wang T., Chan-Yeung M. A cluster of cases of severe acute respiratory syndrome in Hong Kong. N Eng J Med. 2003;348:1977–1985. doi: 10.1056/NEJMoa030666. [DOI] [PubMed] [Google Scholar]
  • 37.Chu C.M., Cheng V.C., Hung I.F., Wong M.M., Chan Kh., Chan K.S. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax. 2004;59(3):252–256. doi: 10.1136/thorax.2003.012658. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.Carvalho W.B., Johnston C., Fonseca M.C. Bronquilite aguda, uma revisão atualizada. Rev Assoc Med Bras. 2007;53(2):182–188. doi: 10.1590/s0104-42302007000200027. [DOI] [PubMed] [Google Scholar]
  • 39.Choi S.H., Hong S.B., Ko G.B., Lee Y., Park H.J., Park S.Y. Viral infection in patients with severe pneumonia requiring intensive care unit admission. Am J Resp Crit Care Med. 2012;186(4):325–332. doi: 10.1164/rccm.201112-2240OC. [DOI] [PubMed] [Google Scholar]
  • 40.Malmström K., Pitkäranta A., Carpen O., Pelkonen A., Malmberg L.P., Turpeinen M. Human rhinovirus in bronchial epithelium of infants with recurrent respiratory symptoms. J Allergy Clin Immunol. 2006;118(3):591–596. doi: 10.1016/j.jaci.2006.04.032. [DOI] [PubMed] [Google Scholar]

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