摘要
目的分析总结鹦鹉热衣原体肺炎患者临床特征,以提高该疾病早期诊断能力及救治水平。方法回顾性分析空军军医大学第一附属医院、吉林大学第一医院二部、西安交通大学第二附属医院呼吸与危重症医学科于2018年1月-2022年1月经宏基因组二代测序(mNGS)方法确诊的14例鹦鹉热衣原体肺炎患者的临床资料,分析总结其临床特点。结果14例患者中仅2例有明确的鸟类或禽类接触史。所有患者均急性高热起病,10例伴呼吸道症状。白细胞计数正常13例,中性粒细胞百分比升高7例。所有患者超敏C反应蛋白、白细胞介素-6、血沉均显著升高。所有患者胸部CT均表现为斑片影和/或实变影,可累及不同肺叶,但所有患者肺下叶均受累。所有患者均经支气管肺泡灌洗液或外周血mNGS检查确诊。经多西环素、米诺环素、莫西沙星、阿奇霉素单药或两药联合方案,13例患者均好转出院,1例死亡。结论高热伴胸部影像学异常应考虑鹦鹉热衣原体肺炎可能,其快速精准诊断有赖于m NGS技术,早期靶向抗生素治疗效果良好。
Objective To analyze and summarize the clinical characteristics of patients with Chlamydia psittaci pneumonia(CPP),and improve the ability of early diagnosis and treatment of this disease.Methods The clinical data of 14 patients with CPP diagnosed by metagenomic next-generation sequencing(mNGS)from January 2018 to January 2022 in the department of respiratory and critical care medicine of the First Affiliated Hospital of Air Force Medical University,the First Hospital of Jilin University-the Eastern Division,the Second Affiliated Hospital of Xi'an Jiaotong University were retrospectively analyzed and summarized.Results Among the 14 patients,only 2 cases had a clear history of exposure to birds or poultry.All patients had acute hyperthermia.A total of 10 cases were accompanied by respiratory symptoms.Laboratory tests showed that white blood cell count was normal in 13 cases,and increased neutrophil proportion in 7 cases.Hypersensitive C-reactive protein,interleukin-6 and erythrocyte sedimentation rate were significantly increased in all patients.Chest computed tomography(CT)of all the patients showed patch shadow and/or consolidation,which may involve different lung lobes,but all patients were involved in the lower lobe of the lung.All patients were confirmed by bronchoalveolar lavage fluid or peripheral blood mNGS.After doxycycline,minocycline,moxifloxacin,azithromycin single drug or two-drug combination regimen,except for one patient died,the other 13 patients recovered and discharged from hospital.Conclusions CPP should be considered for acute hyperpyretic fever with chest imaging abnormalities.Rapid and accurate diagnosis of CPP depends on mNGS technique.Early treatment with targeted antibiotics had a good prognosis.
作者
吴蕾
李敏哲
曹渊
巨清
吕行
陈洁
赵峰
WU Lei;LI Minzhe;CAO Yuan;JU Qing;LÜ Xing;CHEN Jie;ZHAO Feng(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Air Force Medical University,Xi'an,Shaanxi 710032,China;Department of Respiratory and Critical Care Medicine,the First Hospital of Jilin University-the Eastern Division,Changchun,Jilin 130031,China;Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710004,China)
出处
《热带医学杂志》
CAS
2023年第10期1386-1391,共6页
Journal of Tropical Medicine
基金
国家科技重大专项(2017ZX10103004,2017ZX10103004-015)
关键词
鹦鹉热衣原体
肺炎
宏基因组二代测序
Chlamydia psittaci
Pneumonia
Metagenomic next-generation sequencing
作者简介
吴蕾(1989-),女,硕士研究生,主治医师,研究方向为肺部感染与肺癌;通信作者:赵峰,E-mail:xjzhaof@fmmu.edu.cn
