WordNet

relating to or caused by a virus; "viral infection"
respiratory disease characterized by inflammation of the lung parenchyma (excluding the bronchi) with congestion caused by viruses or bacteria or irritants

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ウィルスの;ウィルスが原因の
肺炎

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/07 23:28:56」(JST)

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Viral pneumonia is a pneumonia caused by a virus.^[1] Viruses are one of the two major causes of pneumonia, the other being bacteria; less common causes are fungi and parasites. Viruses are the most common cause of pneumonia in children, while in adults bacteria are a more common cause.^[2]

Signs and symptoms

Symptoms of viral pneumonia include fever, non-productive cough, runny nose, and systemic symptoms (e.g. myalgia, headache). Different viruses cause different symptoms.

Cause

Common causes of viral pneumonia are:

Influenza virus A and B^[3]
Respiratory syncytial virus (RSV)^[3]
Human parainfluenza viruses (in children)^[3]

Rarer viruses that commonly result in pneumonia include:

Adenoviruses (in military recruits)^[3]
Metapneumovirus^[4]
Severe acute respiratory syndrome virus (SARS coronavirus) ^[5]
Middle East respiratory syndrome virus (MERS coronavirus)

Viruses that primarily cause other diseases, but sometimes cause pneumonia include:

Herpes simplex virus (HSV), mainly in newborns or young kids
Varicella-zoster virus (VZV)
Measles virus
Rubella virus
Cytomegalovirus (CMV), mainly in people with immune system problems

The most commonly identified agents in children are respiratory syncytial virus, rhinovirus, human metapneumovirus, human bocavirus, and parainfluenza viruses.^[4]

Pathophysiology

Viruses must invade cells in order to reproduce. Typically, a virus will reach the lungs by traveling in droplets through the mouth and nose with inhalation. There, the virus invades the cells lining the airways and the alveoli. This invasion often leads to cell death either through direct killing by the virus or by self-destruction through apoptosis.

Further damage to the lungs occurs when the immune system responds to the infection. White blood cells, in particular lymphocytes, are responsible for activating a variety of chemicals (cytokines) which cause leaking of fluid into the alveoli. The combination of cellular destruction and fluid-filled alveoli interrupts the transportation of oxygen into the bloodstream.

In addition to the effects on the lungs, many viruses affect other organs and can lead to illness affecting many different bodily functions. Viruses also make the body more susceptible to bacterial infection; for this reason, bacterial pneumonia often complicates viral pneumonia.

Prevention

The best prevention against viral pneumonia is vaccination against influenza, adenovirus, chickenpox, herpes zoster, measles, and rubella.

Treatment

In cases of viral pneumonia where influenza A or B are thought to be causative agents, patients who are seen within 48 hours of symptom onset may benefit from treatment with oseltamivir or zanamivir. Respiratory syncytial virus (RSV) may be treated with ribavirin. Herpes simplex virus and varicella-zoster virus infections are usually treated with aciclovir, whilst ganciclovir is used to treat cytomegalovirus. There is no known efficacious treatment for pneumonia caused by SARS coronavirus, adenovirus, hantavirus, parainfluenza or H1N1 virus^{[citation needed]}; treatment is largely supportive.

Epidemiology

Viral pneumonia occurs in about 200 million people a year which includes about 100 million children and 100 million adults.^[4]

References

^ "viral pneumonia" at Dorland's Medical Dictionary^{[dead link]}
^ National Heart, Lung, and Blood Institute, U.S.A. What Causes Pneumonia?
^ ^a ^b ^c ^d Table 13-7 in: Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson. Robbins Basic Pathology: With STUDENT CONSULT Online Access. Philadelphia: Saunders. ISBN 1-4160-2973-7. 8th edition.
^ ^a ^b ^c Ruuskanen, O; Lahti, E; Jennings, LC; Murdoch, DR (2011-04-09). "Viral pneumonia.". Lancet 377 (9773): 1264–75. doi:10.1016/S0140-6736(10)61459-6. PMID 21435708.
^ http://www.cdc.gov/ncidod/sars/factsheet.htm

UpToDate Contents

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1. 成人における市中肺炎の疫学、病因、および微生物学 epidemiology pathogenesis and microbiology of community acquired pneumonia in adults
2. 小児における市中肺炎：臨床的特徴および診断 community acquired pneumonia in children clinical features and diagnosis
3. 成人における市中肺炎に対する診断的アプローチ diagnostic approach to community acquired pneumonia in adults
4. 小児における肺炎：入院治療 pneumonia in children inpatient treatment
5. 小児における市中肺炎：外来治療 community acquired pneumonia in children outpatient treatment

English Journal

Adaptive Mutations That Occurred during Circulation in Humans of H1N1 Influenza Virus in the 2009 Pandemic Enhance Virulence in Mice.

Otte A1, Sauter M2, Daxer MA3, McHardy AC4, Klingel K2, Gabriel G5.
Journal of virology.J Virol.2015 Jul 15;89(14):7329-37. doi: 10.1128/JVI.00665-15. Epub 2015 May 6.
During the 2009 H1N1 influenza pandemic, infection attack rates were particularly high among young individuals who suffered from pneumonia with occasional death. Moreover, previously reported determinants of mammalian adaptation and pathogenicity were not present in 2009 pandemic H1N1 influenza A vi
PMID 25948752

Reduced Mortality of Cytomegalovirus Pneumonia After Hematopoietic Cell Transplantation Due to Antiviral Therapy and Changes in Transplantation Practices.

Erard V1, Guthrie KA2, Seo S3, Smith J3, Huang M4, Chien J5, Flowers ME6, Corey L7, Boeckh M8.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.Clin Infect Dis.2015 Jul 1;61(1):31-9. doi: 10.1093/cid/civ215. Epub 2015 Mar 16.
BACKGROUND: Despite major advances in the prevention of cytomegalovirus (CMV) disease, the treatment of CMV pneumonia in recipients of hematopoietic cell transplant remains a significant challenge.METHODS: We examined recipient, donor, transplant, viral, and treatment factors associated with overall
PMID 25778751

IFN-α2a or IFN-β1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study.

Shalhoub S1, Farahat F2, Al-Jiffri A3, Simhairi R4, Shamma O5, Siddiqi N6, Mushtaq A7.
The Journal of antimicrobial chemotherapy.J Antimicrob Chemother.2015 Jul;70(7):2129-32. doi: 10.1093/jac/dkv085. Epub 2015 Apr 21.
OBJECTIVES: Middle East respiratory syndrome coronavirus (MERS-CoV) is associated with significant mortality. We examined the utility of plasma MERS-CoV PCR as a prognostic indicator and compared the efficacies of IFN-α2a and IFN-β1a when combined with ribavirin in reducing MERS-CoV-related mortal
PMID 25900158