Haas L E M, Tjan D H T, Schouten M A, van Zanten A R H
Ziekenhuis Gelderse Vallei, Willy Brandtlaan IO, 6716 RP Ede.
Ned Tijdschr Geneeskd. 2006 Jan 21;150(3):117-21.
A 67-year-old man was admitted due to severe pneumonia. Initially he was treated with beta-lactam antibiotics and oxygen. However, he developed respiratory failure and was transferred to the intensive-care unit for mechanical ventilation. He was a bird-keeper who collected many species of exotic birds, including parrots. The diagnosis psittacosis (parrot fever) was confirmed serologically and by PCR on bronchoalveolar lavage fluid. PCR techniques lead to rapid diagnosis which allows for early treatment. The initial treatment of atypical pneumonia with ciprofloxacin failed. After the patient was treated with doxycycline 200 mg i.v. his clinical condition improved and he was cured. The patient was discharged from intensive care after 10 days when acute respiratory-distress syndrome and pericarditis had resolved. Psittacosis is seen sporadically in the Netherlands. It may be encountered more frequently among patients who have had contact with birds and should be considered in the differential diagnosis of atypical pneumonia.
一名67岁男性因严重肺炎入院。起初,他接受了β-内酰胺类抗生素和吸氧治疗。然而,他出现了呼吸衰竭,被转至重症监护病房进行机械通气。他是一名鸟类饲养员,饲养了包括鹦鹉在内的许多种类的珍奇鸟类。通过血清学检测以及支气管肺泡灌洗液的聚合酶链反应(PCR)确诊为鹦鹉热。PCR技术能够实现快速诊断,从而得以早期治疗。用环丙沙星治疗非典型肺炎初期失败。在患者接受静脉注射200毫克强力霉素治疗后,其临床状况改善并痊愈。10天后,急性呼吸窘迫综合征和心包炎消退,患者从重症监护病房出院。鹦鹉热在荷兰偶有发生。在接触过鸟类的患者中可能更常见,在非典型肺炎的鉴别诊断中应予以考虑。