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使用宏基因组下一代测序技术在血液和支气管肺泡灌洗液中检测鹦鹉热衣原体:一例报告。

Detection of Chlamydia psittaci in both blood and bronchoalveolar lavage fluid using metagenomic next-generation sequencing: A case report.

机构信息

Department of Critical Care Medicine.

Department of Neurology, The First People's Hospital of Changde City, Changde, Hunan, China.

出版信息

Medicine (Baltimore). 2021 Jul 9;100(27):e26514. doi: 10.1097/MD.0000000000026514.

Abstract

RATIONALE

Chlamydia psittaci (C psittaci) is a gram-negative obligate intracellular parasite, with birds as main hosts. The main route of infection in humans is inhalation of aerosols from contaminated animal excreta through the respiratory tract. The main manifestation of C psittaci infection is pneumonia. Patients suffering from severe infection are prone to sepsis and multiple organ failure. We report a case of simultaneous detection of C psittaci in blood and bronchoalveolar lavage fluid using metagenomic next-generation sequencing (mNGS) technology.

PATIENT CONCERNS

The 71-year-old male patient was a farmer with a long history of raising poultry and initial symptoms of fever and muscle pain accompanied by limb weakness and paroxysmal cough.

DIAGNOSES

The patient was diagnosed with sepsis, severe pneumonia, and multiple organ failure.

INTERVENTIONS

Anti-infective therapy with doxycycline and meropenem was applied.

OUTCOMES

The patient's body temperature and infection indicators improved and the chest X-ray findings showed the amelioration of lesions after 18 days of treatment. The patient was discharged without treatment on hospital day 19 due to financial constraints and subsequently died after 7 days.

LESSONS

mNGS is an excellent diagnostic tool when specific pathogens are undetected by traditional assays.

摘要

背景

鹦鹉热衣原体(C psittaci)是一种革兰氏阴性专性细胞内寄生虫,以鸟类为主要宿主。人类感染的主要途径是通过呼吸道吸入受污染动物粪便中的气溶胶。C psittaci 感染的主要表现为肺炎。严重感染的患者易发生败血症和多器官衰竭。我们报告了一例使用宏基因组下一代测序(mNGS)技术同时在血液和支气管肺泡灌洗液中检测到 C psittaci 的病例。

病例概述

这名 71 岁男性患者是一名农民,长期饲养家禽,最初出现发热和肌肉疼痛的症状,伴有四肢无力和阵发性咳嗽。

诊断

患者被诊断为败血症、严重肺炎和多器官衰竭。

干预措施

给予多西环素和美罗培南进行抗感染治疗。

结果

经过 18 天的治疗,患者的体温和感染指标得到改善,胸部 X 光检查显示病变改善。由于经济拮据,患者在住院第 19 天出院,随后在 7 天后死亡。

教训

当传统检测方法未检测到特定病原体时,mNGS 是一种出色的诊断工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3690/8270604/3f2e50ab13ec/medi-100-e26514-g001.jpg

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