鹦鹉热衣原体肺炎的临床诊疗特点_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

苏楠 ¹ , 汪泱 ¹ , 宁卫卫 ¹ , 刘超 ¹ , 管小俊 ¹ ,  蒋军红 ^1,2

1. ;
2. ;

Corresponding author：

蒋军红, Email: jiangjunhong1969@suda.edu.cn

Keywords：

鹦鹉热衣原体肺炎; 宏基因二代测序; 多西环素; 支气管肺泡灌洗液

DOI：

10.7507/1671-6205.202204026

Video：

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目的探讨鹦鹉热衣原体肺炎的临床诊疗特点。方法收集2020年9月—2021年12月由苏州大学附属第一医院和附属独墅湖医院呼吸与危重症医学科收治的12例鹦鹉热衣原体肺炎患者的临床资料，进行总结分析。结果 12例患者均以高热、咳嗽为主要表现起病，9例患者接触过鹦鹉，3例接触过活禽。12例患者淋巴细胞计数均不同程度降低，2例患者白细胞、中性粒细胞和降钙素原明显升高；C反应蛋白、红细胞沉降率和D-二聚体均明显升高，而白蛋白水平明显降低，4例患者出现了低钾血症。1例重症患者合并了呼吸衰竭、心力衰竭、肝衰竭、肾衰竭及轻度精神症状。胸部CT均表现为单一肺叶或多肺叶炎症渗出和实变，5例合并有少量胸腔积液。患者初始经验性治疗效果均不理想，支气管肺泡灌洗液宏基因组二代测序技术检测诊断鹦鹉热衣原体肺炎后，及时调整以四环素类药物和（或）喹诺酮类抗生素为基础的治疗方案后病情均好转出院。结论鹦鹉热衣原体肺炎临床相对少见，临床表现以及常规检查很难与其他社区获得性肺炎鉴别，易导致误诊和漏诊，应引起临床医生的重视，宏基因组二代测序技术在鹦鹉热衣原体肺炎诊疗方面具有重要指导意义，值得临床应用和推广。

Citation： 苏楠, 汪泱, 宁卫卫, 刘超, 管小俊, 蒋军红. 鹦鹉热衣原体肺炎的临床诊疗特点. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(9): 665-667. doi: 10.7507/1671-6205.202204026 Copy

1.	Hogerwerf L, DE Gier B, Baan B, et al. Chlamydia psittaci (psittacosis) as a cause of community-acquired pneumonia: a systematic review and meta-analysis. Epidemiol Infect, 2017, 145(15): 3096-3105.
2.	范红. 鹦鹉热, 不容小觑的传染病. 中国呼吸与危重监护杂志, 2022, 21(1): 1-1.
3.	戴枥湾, 朱林霄, 韩晓黎, 等. 鹦鹉热衣原体感染致全身多器官功能障碍综合征一例. 中国呼吸与危重监护杂志, 2022, 21(1): 55-58.
4.	Xiao Q, Shen W, Zou YQ, et al. Sixteen cases of severe pneumonia caused by Chlamydia psittaci in South China investigated via metagenomic next-generation sequencing. J Med Microbiol, 2021, 70(11).
5.	Wang KY, Liu X, Liu HY, et al. Metagenomic diagnosis of severe psittacosis using multiple sequencing platforms. BMC Genomics, 2021, 22(1): 406.
6.	Lei JH, Xu Y, Jiang YF, et al. Clustering cases of Chlamydia psittaci pneumonia in Coronavirus disease 2019 screening ward staff. Clin Infect Dis, 2021, 73(9): e3261-e3265.
7.	Li N, Li SJ, Tan WM, et al. Metagenomic next-generation sequencing in the family outbreak of psittacosis: the first reported family outbreak of psittacosis in China under COVID-19. Emerg Microbes Infect, 2021, 10(1): 1418-1428.
8.	Branley JM, Weston KM, England J, et al. Clinical features of endemic community-acquired psittacosis. New Microbes New Infect, 2014, 2(1): 7-12.
9.	Zhao W, He L, Xie XZ, et al. Clustering cases of Chlamydia psittaci pneumonia mimicking COVID-19 pneumonia. World J Clin Cases, 2021, 9(36): 11237-11247.
10.	姚秀娟, 卢锋峰, 岳文香, 等. 重症社区获得性鹦鹉热肺炎的临床分析. 中国呼吸与危重监护杂志, 2022, 21(1): 2-6.
11.	Qu JM, Zhang J, Chen Y, et al. Aetiology of severe community acquired pneumonia in adults identified by combined detection methods: a multi-centre prospective study in China. Emerg Microbes Infect, 2022, 11(1): 556-566.
12.	陆晓旻, 朱际平, 陈扬, 等. 基于宏基因组二代测序诊断的鹦鹉热衣原体肺炎的流行病学特征分析. 中国临床研究, 2022, 35(1): 1-5.
13.	Yang FX, Li JJ, Qi B, et al. Clinical symptoms and outcomes of severe pneumonia caused by Chlamydia psittaci in Southwest China. Front Cell Infect Microbiol, 2022, 11: 727594.
14.	Yin XW, Mao ZD, Zhang Q, et al. Clinical metagenomic sequencing for rapid diagnosis of pneumonia and meningitis caused by Chlamydia psittaci. World J Clin Cases, 2021, 9(26): 7693-7703.
15.	Gu L, Liu W, Ru M, et al. The application of metagenomic next-generation sequencing in diagnosing Chlamydia psittaci pneumonia: a report of five cases. BMC Pulm Med, 2020, 20(1): 65.
16.	金文芳, 姚羽, 吕艳玲, 等. 8例鹦鹉热衣原体肺炎患者的临床特征分析及其诊治. 中国感染控制杂志, 2022, 21(2): 165-170.
17.	沈凌, 田贤江, 梁荣章, 等. 鹦鹉热衣原体肺炎48例临床特征分析. 中华结核和呼吸杂志, 2021, 44(10): 886-891.
18.	Su SS, Su XQ, Zhou LP, et al. Severe Chlamydia psittaci pneumonia: clinical characteristics and risk factors. Ann Palliat Med, 2021, 10(7): 8051-8060.
19.	朱贞贞, 张宜文. 伐木工人感染鹦鹉热衣原体导致多脏器功能衰竭一例. 中华临床感染病杂志, 2020, 13(3): 218-220.
20.	李元广, 丘韶校, 赵宇. 一例妊娠期鹦鹉热致重症社区获得性肺炎病例报告. 罕少疾病杂志, 2021, 28(6): 8-10.
21.	Zhang AB, Xia XQ, Yuan XL, et al. Severe Chlamydia psittaci pneumonia complicated by Rhabdomyolysis: a case series. Infect Drug Resist, 2022, 15: 873-881.

1. Hogerwerf L, DE Gier B, Baan B, et al. Chlamydia psittaci (psittacosis) as a cause of community-acquired pneumonia: a systematic review and meta-analysis. Epidemiol Infect, 2017, 145(15): 3096-3105.
2. 范红. 鹦鹉热, 不容小觑的传染病. 中国呼吸与危重监护杂志, 2022, 21(1): 1-1.
3. 戴枥湾, 朱林霄, 韩晓黎, 等. 鹦鹉热衣原体感染致全身多器官功能障碍综合征一例. 中国呼吸与危重监护杂志, 2022, 21(1): 55-58.
4. Xiao Q, Shen W, Zou YQ, et al. Sixteen cases of severe pneumonia caused by Chlamydia psittaci in South China investigated via metagenomic next-generation sequencing. J Med Microbiol, 2021, 70(11).
5. Wang KY, Liu X, Liu HY, et al. Metagenomic diagnosis of severe psittacosis using multiple sequencing platforms. BMC Genomics, 2021, 22(1): 406.
6. Lei JH, Xu Y, Jiang YF, et al. Clustering cases of Chlamydia psittaci pneumonia in Coronavirus disease 2019 screening ward staff. Clin Infect Dis, 2021, 73(9): e3261-e3265.
7. Li N, Li SJ, Tan WM, et al. Metagenomic next-generation sequencing in the family outbreak of psittacosis: the first reported family outbreak of psittacosis in China under COVID-19. Emerg Microbes Infect, 2021, 10(1): 1418-1428.
8. Branley JM, Weston KM, England J, et al. Clinical features of endemic community-acquired psittacosis. New Microbes New Infect, 2014, 2(1): 7-12.
9. Zhao W, He L, Xie XZ, et al. Clustering cases of Chlamydia psittaci pneumonia mimicking COVID-19 pneumonia. World J Clin Cases, 2021, 9(36): 11237-11247.
10. 姚秀娟, 卢锋峰, 岳文香, 等. 重症社区获得性鹦鹉热肺炎的临床分析. 中国呼吸与危重监护杂志, 2022, 21(1): 2-6.
11. Qu JM, Zhang J, Chen Y, et al. Aetiology of severe community acquired pneumonia in adults identified by combined detection methods: a multi-centre prospective study in China. Emerg Microbes Infect, 2022, 11(1): 556-566.
12. 陆晓旻, 朱际平, 陈扬, 等. 基于宏基因组二代测序诊断的鹦鹉热衣原体肺炎的流行病学特征分析. 中国临床研究, 2022, 35(1): 1-5.
13. Yang FX, Li JJ, Qi B, et al. Clinical symptoms and outcomes of severe pneumonia caused by Chlamydia psittaci in Southwest China. Front Cell Infect Microbiol, 2022, 11: 727594.
14. Yin XW, Mao ZD, Zhang Q, et al. Clinical metagenomic sequencing for rapid diagnosis of pneumonia and meningitis caused by Chlamydia psittaci. World J Clin Cases, 2021, 9(26): 7693-7703.
15. Gu L, Liu W, Ru M, et al. The application of metagenomic next-generation sequencing in diagnosing Chlamydia psittaci pneumonia: a report of five cases. BMC Pulm Med, 2020, 20(1): 65.
16. 金文芳, 姚羽, 吕艳玲, 等. 8例鹦鹉热衣原体肺炎患者的临床特征分析及其诊治. 中国感染控制杂志, 2022, 21(2): 165-170.
17. 沈凌, 田贤江, 梁荣章, 等. 鹦鹉热衣原体肺炎48例临床特征分析. 中华结核和呼吸杂志, 2021, 44(10): 886-891.
18. Su SS, Su XQ, Zhou LP, et al. Severe Chlamydia psittaci pneumonia: clinical characteristics and risk factors. Ann Palliat Med, 2021, 10(7): 8051-8060.
19. 朱贞贞, 张宜文. 伐木工人感染鹦鹉热衣原体导致多脏器功能衰竭一例. 中华临床感染病杂志, 2020, 13(3): 218-220.
20. 李元广, 丘韶校, 赵宇. 一例妊娠期鹦鹉热致重症社区获得性肺炎病例报告. 罕少疾病杂志, 2021, 28(6): 8-10.
21. Zhang AB, Xia XQ, Yuan XL, et al. Severe Chlamydia psittaci pneumonia complicated by Rhabdomyolysis: a case series. Infect Drug Resist, 2022, 15: 873-881.

Chinese Journal of Respiratory and Critical Care Medicine

鹦鹉热衣原体肺炎的临床诊疗特点

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