目的 探讨鹦鹉热衣原体肺炎的临床特点。 方法 本研究为观察性研究，采用非随机抽样法收集2021年4月至2023年7月北京市海淀医院呼吸与危重症医学科收治的11例鹦鹉热衣原体肺炎患者的病例资料，包括一般信息、流行病学史、临床症状、实验室检查、胸部影像学资料、治疗方案和预后等指标。分析其临床特点。 结果 7例患者有鸟类接触史。临床症状为高热、咳嗽、呼吸困难、肌痛等。10例外周血白细胞总数正常，C反应蛋白均明显升高。10例谷丙转氨酶及谷草转氨酶升高。D-二聚体、N-端B型钠尿肽前体均升高。5例肌酸激酶升高，4例肌酐升高，8例有低钠血症。胸部影像学典型特征为肺实变影，可见支气管充气征。4例见磨玻璃影，5例有胸腔积液。5例合并呼吸衰竭，3例发展为重症肺炎，2例出现急性呼吸窘迫综合征，2例合并横纹肌溶解。所有患者经宏基因组二代测序确诊。确诊后10例以四环素类为基础治疗，8例应用多西环素，2例应用奥马环素。1例单用阿奇霉素。所有患者好转出院。 结论 鹦鹉热衣原体肺炎可合并横纹肌溶解，部分进展为重症肺炎，出现急性呼吸窘迫综合征，累及多器官。宏基因组二代测序能快速确诊。以四环素类为基础的综合治疗，疗效良好。 Objective To explore the clinical features of Chlamydia psittaci (C。psittaci) pneumonia。 Methods This study was an observational study。Non-random sampling method was used。Clinical data of 11 patients with C。 Psittaci pneumonia in the department of Rrespiratory and Critical Care Medicine of Beijing Haidian Hospital from April 2021 to July 2023 were collected and analyzed。The clinical data included general information， epidemiology history， clinical symptoms， laboratory examination， chest imaging， treatment plan and prognosis etc。 Results Seven cases had a history of bird contact。High fever， cough， dyspnea， and muscle pain were common clinical manifestations。Blood routine test showed that 10 patients had normal white blood cell count。C-reactive protein level was significant elevated in all cases。Ten cases had increased alanine aminotransferase and aspartate aminotransferase。D-dimer and N-terminal B-type natriuretic peptide precursor were both increased。Five cases had increased creatine kinase， 4 cases had elevated creatinine， and 8 cases had hyponatremia。Chest imaging typically showed lung consolidation with bronchial inflation sign。Four patients were with ground-glass opacity， 5 patients were complicated with pleural effusion， 5 cases were combined with respiratory failure， 3 cases progressed to severe pneumonia， 2 patients were complicated with acute respiratory distress syndrome， and 2 patients were complicated with rhabdomyolysis。The pathogenic diagnosis was confirmed by metagenomic next-generation sequencing in all patients。After diagnosis， 10 patients were treated based on tetracyclines， 8 patients were treated with doxycycline， 2 patients were treated with omacycline， and 1 patient was treated with azithromycin alone。All patients were discharged from the hospital after their condition improved。 Conclusions Chlamydia psittaci pneumonia may combine rhabdomyolysis。Some cases may progress to severe pneumonia， combine acute respiratory distress syndrome， and have multiple organ involvement。Metagenomic next-generation sequencing can quickly and accurately diagnose the disease。The combined treatment based on tetracyclines shows good effect。
Clinical characteristics of 11 cases of Chlamydia psittaci pneumonia
Objective To explore the clinical features of Chlamydia psittaci (C.psittaci) pneumonia. Methods This study was an observational study.Non-random sampling method was used.Clinical data of 11 patients with C. Psittaci pneumonia in the department of Rrespiratory and Critical Care Medicine of Beijing Haidian Hospital from April 2021 to July 2023 were collected and analyzed.The clinical data included general information, epidemiology history, clinical symptoms, laboratory examination, chest imaging, treatment plan and prognosis etc. Results Seven cases had a history of bird contact.High fever, cough, dyspnea, and muscle pain were common clinical manifestations.Blood routine test showed that 10 patients had normal white blood cell count.C-reactive protein level was significant elevated in all cases.Ten cases had increased alanine aminotransferase and aspartate aminotransferase.D-dimer and N-terminal B-type natriuretic peptide precursor were both increased.Five cases had increased creatine kinase, 4 cases had elevated creatinine, and 8 cases had hyponatremia.Chest imaging typically showed lung consolidation with bronchial inflation sign.Four patients were with ground-glass opacity, 5 patients were complicated with pleural effusion, 5 cases were combined with respiratory failure, 3 cases progressed to severe pneumonia, 2 patients were complicated with acute respiratory distress syndrome, and 2 patients were complicated with rhabdomyolysis.The pathogenic diagnosis was confirmed by metagenomic next-generation sequencing in all patients.After diagnosis, 10 patients were treated based on tetracyclines, 8 patients were treated with doxycycline, 2 patients were treated with omacycline, and 1 patient was treated with azithromycin alone.All patients were discharged from the hospital after their condition improved. Conclusions Chlamydia psittaci pneumonia may combine rhabdomyolysis.Some cases may progress to severe pneumonia, combine acute respiratory distress syndrome, and have multiple organ involvement.Metagenomic next-generation sequencing can quickly and accurately diagnose the disease.The combined treatment based on tetracyclines shows good effect.
万方数据
