鸚鵡熱衣原體肺炎的臨床診療特點_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

蘇楠 ¹ , 汪泱 ¹ , 寧衛衛 ¹ , 劉超 ¹ , 管小俊 ¹ ,  蔣軍紅 ^1,2

1. ;
2. ;

Corresponding?author：

蔣軍紅, Email: jiangjunhong1969@suda.edu.cn

Keywords：

鸚鵡熱衣原體肺炎; 宏基因二代測序; 多西環素; 支氣管肺泡灌洗液

DOI：

10.7507/1671-6205.202204026

Video：

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目的探討鸚鵡熱衣原體肺炎的臨床診療特點。方法收集2020年9月—2021年12月由蘇州大學附屬第一醫院和附屬獨墅湖醫院呼吸與危重癥醫學科收治的12例鸚鵡熱衣原體肺炎患者的臨床資料，進行總結分析。結果 12例患者均以高熱、咳嗽為主要表現起病，9例患者接觸過鸚鵡，3例接觸過活禽。12例患者淋巴細胞計數均不同程度降低，2例患者白細胞、中性粒細胞和降鈣素原明顯升高；C反應蛋白、紅細胞沉降率和D-二聚體均明顯升高，而白蛋白水平明顯降低，4例患者出現了低鉀血癥。1例重癥患者合并了呼吸衰竭、心力衰竭、肝衰竭、腎衰竭及輕度精神癥狀。胸部CT均表現為單一肺葉或多肺葉炎癥滲出和實變，5例合并有少量胸腔積液。患者初始經驗性治療效果均不理想，支氣管肺泡灌洗液宏基因組二代測序技術檢測診斷鸚鵡熱衣原體肺炎后，及時調整以四環素類藥物和（或）喹諾酮類抗生素為基礎的治療方案后病情均好轉出院。結論鸚鵡熱衣原體肺炎臨床相對少見，臨床表現以及常規檢查很難與其他社區獲得性肺炎鑒別，易導致誤診和漏診，應引起臨床醫生的重視，宏基因組二代測序技術在鸚鵡熱衣原體肺炎診療方面具有重要指導意義，值得臨床應用和推廣。

Citation： 蘇楠, 汪泱, 寧衛衛, 劉超, 管小俊, 蔣軍紅. 鸚鵡熱衣原體肺炎的臨床診療特點. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(9): 665-667. doi: 10.7507/1671-6205.202204026 Copy

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2.	范紅. 鸚鵡熱, 不容小覷的傳染病. 中國呼吸與危重監護雜志, 2022, 21(1): 1-1.
3.	戴櫪灣, 朱林霄, 韓曉黎, 等. 鸚鵡熱衣原體感染致全身多器官功能障礙綜合征一例. 中國呼吸與危重監護雜志, 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, 盧鋒峰, 岳文香, 等. 重癥社區獲得性鸚鵡熱肺炎的臨床分析. 中國呼吸與危重監護雜志, 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.	陸曉旻, 朱際平, 陳揚, 等. 基于宏基因組二代測序診斷的鸚鵡熱衣原體肺炎的流行病學特征分析. 中國臨床研究, 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, 呂艷玲, 等. 8例鸚鵡熱衣原體肺炎患者的臨床特征分析及其診治. 中國感染控制雜志, 2022, 21(2): 165-170.
17.	沈凌, 田賢江, 梁榮章, 等. 鸚鵡熱衣原體肺炎48例臨床特征分析. 中華結核和呼吸雜志, 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.	朱貞貞, 張宜文. 伐木工人感染鸚鵡熱衣原體導致多臟器功能衰竭一例. 中華臨床感染病雜志, 2020, 13(3): 218-220.
20.	李元廣, 丘韶校, 趙宇. 一例妊娠期鸚鵡熱致重癥社區獲得性肺炎病例報告. 罕少疾病雜志, 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. 范紅. 鸚鵡熱, 不容小覷的傳染病. 中國呼吸與危重監護雜志, 2022, 21(1): 1-1.
3. 戴櫪灣, 朱林霄, 韓曉黎, 等. 鸚鵡熱衣原體感染致全身多器官功能障礙綜合征一例. 中國呼吸與危重監護雜志, 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, 盧鋒峰, 岳文香, 等. 重癥社區獲得性鸚鵡熱肺炎的臨床分析. 中國呼吸與危重監護雜志, 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. 陸曉旻, 朱際平, 陳揚, 等. 基于宏基因組二代測序診斷的鸚鵡熱衣原體肺炎的流行病學特征分析. 中國臨床研究, 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, 呂艷玲, 等. 8例鸚鵡熱衣原體肺炎患者的臨床特征分析及其診治. 中國感染控制雜志, 2022, 21(2): 165-170.
17. 沈凌, 田賢江, 梁榮章, 等. 鸚鵡熱衣原體肺炎48例臨床特征分析. 中華結核和呼吸雜志, 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. 朱貞貞, 張宜文. 伐木工人感染鸚鵡熱衣原體導致多臟器功能衰竭一例. 中華臨床感染病雜志, 2020, 13(3): 218-220.
20. 李元廣, 丘韶校, 趙宇. 一例妊娠期鸚鵡熱致重癥社區獲得性肺炎病例報告. 罕少疾病雜志, 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

鸚鵡熱衣原體肺炎的臨床診療特點

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