Severe adenovirus pneumonia has a high mortality and incidence of sequelae. Fever and cough are the main symptoms of children's severe adenovirus pneumonia, but such clinical manifestations are lack of specificity. For children with persistent high fever who are in the epidemic age and season, the adenovirus etiology detection, blood routine, cytokines, T cell subsets and imaging examinations are suggested. Children with early manifestations of infiltration of lung segment and lobar parenchyma, obvious emphysema, interstitial pneumonia or a large amount of pleural effusion should be alerted to have severe adenovirus pneumonia. This article reviews the epidemiological characteristics and risk factors of adenovirus pneumonia in different seasons, regions and serology, and the laboratory findings and imaging features of severe adenovirus pneumonia, which would be helpful for the early identification of the disease.
重症腺病毒肺炎患儿具有较高的病死率及后遗症发生率。儿童重症腺病毒肺炎以发热、咳嗽为主要症状，无明显特异性。一般来说，对于处于好发年龄及流行季节内的儿童，出现持续高热不退，应早期完善腺病毒病原学检测、血常规、细胞因子、T细胞亚群等检测及影像学检查。其中，影像学检查发现早期表现为肺段及大叶实质浸润、明显肺气肿、间质性肺炎改变或合并大量胸腔积液的患儿，应警惕为重症腺病毒肺炎。本文综述了腺病毒肺炎不同季节、地区、血清学的流行病学特点，重症腺病毒肺炎的高危因素、实验室检测及影像学早期表现，以期为重症腺病毒肺炎的早期识别提供参考。