Background. Nonresponding pneumonia is responsible for the most mortality of community-acquired pneumonia (CAP). However, thus far, it is not clear whether viral infection plays an important role in the etiology of nonresponding CAP and whether there is a significant difference in the clinical characteristics between viral and nonviral nonresponding CAP. Methods. From 2016 to 2019, nonresponding CAP patients were retrospectively enrolled in our study. All patients received bronchoalveolar lavage (BAL) and virus detection in BAL fluid by multiplex real-time polymerase chain reaction (PCR), and clinical, laboratory, and radiographic data were collected. Results. A total of 43 patients were included. The median age was 62 years, and 65.1% of patients were male. Overall, 20 patients (46.5%) were identified with viral infection. Of these viruses, influenza virus (n = 8) and adenovirus (n = 7) were more frequently detected, and others included herpes simplex virus, human enterovirus, cytomegalovirus, human coronavirus 229E, rhinovirus, and parainfluenza virus. Compared with nonviral nonresponding CAP, only ground-glass opacity combined with consolidation was a more common imaging manifestation in viral nonresponding CAP. However, no obvious differences were found in clinical and laboratory findings between the presence and the absence of viral infections. Conclusions. Viral infections were particularly frequent in adults with nonresponding CAP. The ground-glass opacity combined with consolidation was a specific imaging manifestation for viral nonresponding CAP, while the clinical and laboratory data showed no obvious differences between viral and nonviral nonresponding CAP.

中文翻译：

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无反应性社区获得性肺炎患者支气管肺泡灌洗液中多重实时聚合酶链反应检测病毒

背景。无反应性肺炎是导致社区获得性肺炎（CAP）死亡率最高的原因。但是，到目前为止，尚不清楚病毒感染是否在无反应性CAP的病因中起重要作用，以及病毒性和无病毒无反应性CAP的临床特征是否存在显着差异。方法。从2016年至2019年，无反应的CAP患者被回顾性纳入我们的研究。所有患者均接受了支气管肺泡灌洗（BAL），并通过多重实时聚合酶链反应（PCR）检测了BAL液中的病毒，并收集了临床，实验室和X线照片。结果。总共包括43例患者。中位年龄为62岁，其中65.1％为男性。总体上，鉴定出20例（46.5％）病毒感染患者。在这些病毒中， 更经常检测到流感病毒（n  = 8）和腺病毒（n = 7），其他包括单纯疱疹病毒，人肠病毒，巨细胞病毒，人冠状病毒229E，鼻病毒和副流感病毒。与非病毒无应答CAP相比，病毒性无应答CAP中仅玻璃杯混浊结合巩固是更常见的影像学表现。但是，无论是否存在病毒感染，在临床和实验室检查结果中均未发现明显差异。结论。在CAP无反应的成年人中，病毒感染尤为常见。毛玻璃样混浊结合巩固是病毒无反应性CAP的一种特殊的影像学表现，而临床和实验室数据表明，病毒性无反应性CAP与无病毒的无反应性CAP之间无明显差异。