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鹦鹉热衣原体感染致妊娠: 1 例报告并文献复习。

Gestational psittacosis: A case report and literature review.

机构信息

Department of Obstetrics and Gynecology, Shiga University of Medical Science Hospital, Otsu, Japan.

Department of Emergency and Critical Care Medicine, Shiga University of Medical Science Hospital, Otsu, Japan.

出版信息

J Obstet Gynaecol Res. 2020 May;46(5):673-677. doi: 10.1111/jog.14217. Epub 2020 Feb 19.

Abstract

Gestational psittacosis is a rare disease that is associated with significant maternal and fetal morbidity and mortality. Currently, there is no examination method which allows for a quick diagnosis. We report a case of gestational psittacosis that could not be diagnosed as psittacosis during treatment and resulted in maternal and fetal death despite intensive treatment. We also reviewed 23 cases of gestational psittacosis. Fetal and maternal mortality was 82.6% (19/23) and 8.7% (2/23), respectively. In pregnant women with high fever and flu-like symptoms, we should suspect Chlamydia psittaci infection if at least one of the following is present; contact with sheep, parrots, parakeets or goats; normal or moderately decreased leucocyte count, thrombocytopenia and hepatic and/or renal dysfunction; cough and/or lobe consolidation or infiltration on chest X-ray. Antibiotic therapy with macrolide prenatally, macrolide or tetracycline postnatally and termination of pregnancy should be considered.

摘要

鹦鹉热衣原体感染性肺炎又称鹦鹉热,是一种罕见的疾病,可导致孕妇和胎儿发生严重的并发症和死亡。目前,尚无快速诊断方法。我们报告了 1 例鹦鹉热衣原体感染性肺炎,该患者尽管接受了积极的治疗,但在治疗过程中无法明确诊断为鹦鹉热,最终导致母婴死亡。我们还回顾性分析了 23 例鹦鹉热衣原体感染性肺炎患者,母婴死亡率分别为 82.6%(19/23)和 8.7%(2/23)。对于出现高热和流感样症状的孕妇,如果符合以下至少一项,应怀疑鹦鹉热衣原体感染:接触绵羊、鹦鹉、长尾小鹦鹉或山羊;白细胞计数正常或中度减少、血小板减少和肝肾功能障碍;胸部 X 线检查提示咳嗽和/或肺叶实变或浸润。应考虑产前使用大环内酯类药物、产后使用大环内酯类或四环素类药物以及终止妊娠。

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