摘要
目的探讨分析鹦鹉热衣原体肺炎患者的临床表现及辅助检查结果特征,以提高对该病的认识。方法回顾性分析某医院2019年6月—2021年8月经宏基因组二代测序(mNGS)诊断鹦鹉热衣原体肺炎的9例患者临床资料。结果9例患者中男性7例,女性2例,包含1例妊娠36^(+2)周孕妇;年龄25~70岁,中位年龄63岁;临床主要表现为高热(9例)、咳嗽(9例)、咳痰(7例)。白细胞计数正常8例,淋巴细胞计数降低9例,CRP升高9例,ESR升高9例,PCT正常4例,门冬氨酸氨基转移酶和丙氨酸氨基转移酶升高6例。9例患者胸部CT均表现为斑片或斑片实变影。经血及肺泡灌洗液mNGS确诊后使用多西环素、莫西沙星、左氧氟沙星、阿奇霉素单药治疗方案,疗程14~21 d,均好转出院。结论鹦鹉热衣原体肺炎临床表现多样、诊断困难,mNGS检测可以快速明确病原学诊断,有助于及时启动特异性抗感染治疗,可减少抗菌药物的使用,改善预后。
Objective To explore and analyze features of clinical manifestations and auxiliary examination results of patients with Chlamydia psittaci(C.psittaci)pneumonia,and improve the understanding of the disease.Methods Clinical data of 9 patients with C.psittaci pneumonia diagnosed by metagenomic next-generation sequencing(mNGS)in a hospital from June 2019 to August 2021 were retrospectively analyzed.Results Among 9 patients,7 were males and 2 were females,including a pregnant woman who was 36^(+2) weeks pregnancy;patients were aged 25-70 years,with a median age of 63 years;the main clinical manifestations were high fever(n=9),cough(n=9)and expectoration(n=7).Eight patients’leukocyte count was normal,9 patients’lymphocyte count decreased,9 patients’C-reactive protein(CRP)increased,9 patients’erythrocyte sedimentation rate(ESR)increased,4 patients’procalcitonin(PCT)was normal,6 patients’aspartate aminotransferase(AST)and alanine aminotransferase(ALT)increased.Chest CT of all patients showed patchy or patchy consolidation.After confirmed by mNGS of blood and bronchoalveolar lavage fluid,monotherapy of doxycycline,moxifloxacin,levofloxacin,and azithromycin were administered for 14-21 days,all patients were cured and discharged from hospital.Conclusion C.psittaci pneumonia has a variety of clinical manifestations and is difficult to be diagnosed,mNGS test can quickly identify the etiology,facilitate the timely initiation of specific anti-infective therapy,reduce antimicrobial use,and improve the prognosis.
作者
刘斌
谢波
黄彭
刘双柏
梁彦超
刘毅
陈芳玮
贺晓艳
LIU Bin;XIE Bo;HUANG Peng;LIU Shuang-bo;LIANG Yan-chao;LIU Yi;CHEN Fang-wei;HE Xiao-yan(Department of Respiratory and Critical Care Medicine;Medi-cal Administration Department,Zhuzhou Hospital Affiliated to Xiangya School of Medicine,Central South University,Zhuzhou 412007,China;Emergency Department,Zhuzhou Central Hospital,Zhuzhou Hospital Affiliated to Xiangya School of Medicine,Central South University,Zhuzhou 412007,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2022年第2期159-164,共6页
Chinese Journal of Infection Control
关键词
鹦鹉热衣原体
肺炎
宏基因组二代测序
临床特点
肺泡灌洗液
Chlamydia psittaci
pneumonia
next-generation sequencing
clinical feature
bronchoalveolar lavage fluid
