1例联合接种两种疫苗偶合不明病原体颅内感染的调查.docVIP

1例联合接种两种疫苗偶合不明病原体颅内感染的调查 　　【摘要】 目的：调查某1例联合接种两种疫苗发生不明病原体颅内感染的病例是否属于预防接种异常反应。方法：对病例开展个案调查，收集资料、汇总分析等，并提出相关诊断结论等。结果：该病例在接种腮腺炎减毒活疫苗、水痘减毒活疫苗1 d后，无明显诱因发病，主要症状有发热、抽搐。先后在市级医院和省级医院住院治疗，主要诊断为重症脑炎、脓毒症、颅内感染和支气管炎；病例血清、脑脊液均未培养，分离出病毒、细菌，相关病毒抗体IgM检测阴性。市级预防接种异常反应调查诊断意见认为，该病例的临床表现与其接种的两种疫苗不存在完整的临床证据链条，现有资料不能证实该病例发生的颅内感染与疫苗有关。结论：病例不属于预防接种异常反应，应判断为偶合症。 　　【关键词】 疫苗； 病毒； 感染； 腮腺炎； 水痘 　　中图分类号 R186 文献标识码 B 文章编号 1674-6805（2015）35-0088-04 　　A Case of a Survey of Joint Two Kinds of Vaccination Coupled with Unknown Pathogen Intracranial Infection/MA Jing-cang，HE Xu-ying.//Chinese and Foreign Medical Research，2015，13（35）：88-91 　　【Abstract】 Objective：To investigate whether a joint two vaccine unknown pathogens intracranial infection belongs to the vaccination abnormal reaction or not.Method：Investigated the case，collected and analyzed the data，and putted forward the diagnostic reports.Result：After 1 day of the case vaccinated with live attenuated mumps vaccination and live attenuated varicella vaccination history later，the case had main symptoms of fever，convulsions with no obvious inducement.The case had treatment successively in a municipal hospital and a provincial hospital，and the main diagnosis were severe encephalitis，sepsis，intracranial infection and bronchitis；No virus or bacteria was cultivated，viruses，bacteria were isolated；No related positive IgM antibody of virus was detected.The opinions of municipal Immunization Survey diagnosis expert group for the diagnosis were that there were no chain evidences between the clinical manifestation and the two kinds of vaccination，and the clinical data available could not support the relevance between the occurrence of intracranial infection and the Vaccination.Conclusion：The case was not an AEFI case，which could be judged as a coupling case. 　　【Key words】 Vaccine； Virus； Infection； Mumps； Varicella 　　First-author’s address：Heze Center for Disease Control and Prevention，Heze 274010，China 　　doi：10.14033/j.cnki.cfmr.2015.35.042 　　随着我国经济和社