摘要
目的:探讨经mNGS确诊的鹦鹉热衣原体肺炎临床特点及胸部CT表现。方法:回顾性分析2020年8月-2023年10月在本院经mNGS确诊的48例鹦鹉热衣原体肺炎患者的临床资料、首次及1个月内胸部CT表现。结果:48例均有发热症状,其中40例(83.3%)有禽类接触史;白细胞计数轻度升高12例(25%),中性粒细胞百分数升高33例(68.8%);C反应蛋白升高42例(87.5%),其中29例(60.4%)C反应蛋白>100 mg/L。首次胸部CT检查显示病变位于下叶41例(85.4%),35例(72.9%)累及单个肺叶,均沿胸膜下或支气管血管束周围分布,最常见表现为实变(97.9%,47/48),且实变多伴随空气支气管征(97.9%,46/47)及晕征(74.5%,35/47),18例(37.5%)有细网格征,18例(37.5%)病变同侧可见胸腔积液。经抗生素治疗后45例复查CT显示病灶好转30例(66.7%),10例(22.2%)出现纤维灶,18例(40.0%)晕征及14例(31.1%)细网格征吸收消失。结论:鹦鹉热衣原体肺炎的胸部CT多表现为下叶为主实变伴空气支气管征及周围磨玻璃影,常合并细网格征及胸腔积液。
Objective:The purpose of this study was to investigate the clinical features and chest CT findings of Chlamydia psittaci pneumonia confirmed by metagenomic next-generation sequencing(mNGS).Methods:The clinical data and chest CT findings(the first CT and follow-up CT within one month)of 48 patients in our hospital with Chlamydia psittaci pneumonia confirmed by mNGS between August 2020 and October 2023 were retrospectively analyzed.Results:Among the 48 patients,40 cases(83.3%)had an exposure history to poultry.All cases had fever.White blood cells were elevated in 12 cases(25.0%),proportion of neutrophils was elevated in 33 cases(68.8%),and C-reactive protein was elevated in 42 cases(87.5%),with C-reactive protein>100mg/L in 29 cases(60.4%).The first chest CT scan showed that the lesion was located in the lower lobe in 41 cases,single lobe involvement in 35 cases(72.9%),all the lesions were peripheral distribution or along the bronchovascular bundle,the most common finding was consolidation(97.9%,47/48)with air bronchogram(97.9%,46/47)and halo sign(74.5%,35/47),crazy-paving appearance in 18 cases(37.5%),ipsilateral pleural effusion in 18 cases(37.5%).After adjustment of antibiotic treatment,the follow-up CT of 45 cases showed improved in 30 cases(66.7%),fibrous lesions in 10 cases(22.2%).The halo sign and crazy-paving appearance were absorbed in 18 cases(40.0%)and 14 cases(31.1%)on the follow-up CT images.Conclusion:The chest CT manifestations of Chlamydia psittaci pneumonia are mostly showed as consolidation in the lower lobes with air bronchogram sign and halo sign,often accompany with crazy-paving appearance and pleural effusion.
作者
王迪
胡维娟
贾科峰
叶玉冰
吕蓉
WANGDi;HU Wei-juan;JIA Ke-feng(Department of Radiology,the Third Central Hospital of Tianjin,Tianjin Institute of Hepatobiliary Disease,Tianjin Key Laboratory of Artificial Cell,Artificial Cell Engineering Technology Research of Public Health Ministry,Tianjin 300170,China)
出处
《放射学实践》
CSCD
北大核心
2024年第12期1593-1597,共5页
Radiologic Practice
基金
天津市医学重点学科(专科)建设项目(TJYXZDXK-074C)。
