摘要
目的:总结分析北京大学第一医院密云院区11例鹦鹉热衣原体肺炎患者的临床和流行病特征。方法:回顾性分析2020年12月-2021年8月北京大学第一医院密云院区呼吸科集中确诊的11例鹦鹉热衣原体肺炎患者的临床和流行病学资料。结果:11例患者中男4例,女7例,均有鸟类接触史,6例患者家养鸟类同期出现腹泻或死亡。10例患者冬季发病。11例患者共涉及4起聚集性肺炎,1起涉及同村5人肺炎,确诊2例;另3起涉及无关联的3对夫妻,其中5人确诊;剩余4例为散发病例。患者临床表现为稽留高热11例,乏力7例,咳嗽6例,呼吸困难6例,肌肉疼痛6例等。所有患者外周血CRP均显著升高。10例患者行血气分析,低氧血症9例,呼吸衰竭3例。胸部高分辨CT(HRCT)检查,11例均显示为肺实变影、其中累及单侧单肺叶6例,双侧肺叶4例,单侧多肺叶1例,胸腔积液5例。所有患者均接受了莫西沙星经验性抗感染治疗,确诊后均加用米诺环素治疗。10例患者治愈出院,1例患者死亡。结论:鹦鹉热衣原体肺炎患者常有明确鸟类接触史,可散发,也可呈小规模聚集发病,冬季为高发季节,临床主要表现为稽留高热,伴头痛、肌肉关节疼痛及乏力等全身症状,胸部HRCT主要表现为肺实变影,常累及多个肺叶,并伴有胸腔积液。多数患者预后良好,部分患者可发展为重症肺炎,严重者可导致死亡。
Objective:To summarize and analyze the clinical and epidemiological characteristics of 11 patients with Chlamydia psittaci pneumonia in Miyun District,Peking University First Hospital.Method:The clinical and epidemiological data of 11 patients with Chlamydia psittaci pneumonia centrally diagnosed in the Respiratory Department of Miyun District,Peking University First Hospital from December 2020 to August 2021 were retrospectively analyzed.Result:There were 4 males and 7 females in the 11 patients,all of them had a history of bird contact,and 6 patients had diarrhea or death of domestic birds at the same time.Ten patients developed in winter.11 patients were involved in 4 cases of aggregation pneumonia,1 case involved in 5 people of pneumonia in the same village,2 cases were diagnosed;other 3 cases involved three unrelated couples,of which 5 were diagnosed and the remaining 4 were sporadic cases.The clinical manifestations of the patients included prolonged high fever(11 cases),fatigue(7 cases),cough(6 cases),dyspnea(6 cases),and muscle pain(6 cases).C-reactive protein in peripheral blood of all patients was significantly increased.Blood gas analysis was performed in 10 patients,including 9 cases of hypoxemia and 3 cases of respiratory failure.High-resolution computed tomography(HRCT)examination,11 cases showed lung consolidation shadow,including unilateral single pulmonary lobe in 6 cases,bilateral pulmonary lobes in 4 cases,unilateral multiple lobes in 1 case,pleural effusion in 5 cases.All patients received Moxifloxacin empirical anti infective treatment,and were treated with Minocycline after diagnosis.Ten patients were cured and one patient died.Conclusion:Patients with Chlamydia psittaci pneumonia often have a clear history of bird contact,and may develop sporadic or in small clusters.The high incidence season is winter.The main clinical manifestations are continued high fever,headache,muscle and joint pain,fatigue and other systemic symptoms.Chest HRCT mainly shows consolidation of lung,often involving mult
作者
张长强
郭松喜
刘茜
王征
王国娜
解建茹
张元兵
张恩花
王春红
牟向东
ZHANG Changqiang;GUO Songxi;LIU Qian;WANG Zheng;WANG Guona;XIE Jianru;ZHANG Yuanbing;ZHANG Enhua;WANG Chunhong;MU Xiangdong(Miyun District,Peking University First Hospital,Beijing 101500,China;不详)
出处
《中外医学研究》
2022年第15期25-29,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
清华大学春风基金国内科研专项项目(2020Z99CFY033)
北京市属医院科研培育计划项目(PX2020041)
国家重点研发计划项目(2020YFC2005401)。
关键词
鹦鹉热衣原体
肺炎
临床表现
诊断
治疗
Chlamydia psittaci
Pneumonia
Clinical characteristics
Diagnosis
Treatment
