Qi Y F, Huang J L, Chen J H, Huang C P, Li Y H, Guan W J
Pulmonary and Critical Care Medicine, Central Hospital of Panyu District, Guangzhou 511400, China.
Guanzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2021 Sep 12;44(9):806-811. doi: 10.3760/cma.j.cn112147-20210228-00137.
To analyze the clinical characteristics and the diagnosis and treatment of pneumonia complicated with rhabdomyolysis. We reported a case of pneumonia complicated with rhabdomyolysis. We did a literature review on the published reports between January 1978 and May 2020 by searching with the key words of "psittacosis" or "i" and "rhabdomyolysis" in the PubMed database (time frame: January 1, 1967 to May 30, 2020). Our patient was a 64-year-old male presenting with high-grade fever, fatigue, myalgia and dyspnea. A computed tomographic scan of the chest revealed bilateral pneumonia, which was further complicated with rhabdomyolysis during disease progression. This prompted the metagenomic next-generation sequencing, revealing the sequences of in both the bronchoalveolar lavage fluid and blood. Of the 11 cases in the 3 literature reports that we retrieved, 5 had concomitant rhabdomyolysis (two of which did not have complete clinical information), and the other 6 cases had myositis complicated with an elevated level of creatine phosphokinase. This yielded 3 cases with complete clinical information for our analysis. We had further incorporated their information with the single case managed within our study site. Two were males and the other 2 were females. The patients were aged 66, 46, 44 and 64 years, respectively. All cases had fever and 3 had a contact history with live poultry. Two cases had myalgia and progressed rapidly into having respiratory failure, and the other 2 cases did not develop myalgia and improved significantly after a timely treatment. All 4 cases were cured and discharged after treatment with appropriate antibiotics. No adverse outcomes were observed. The prognosis of pneumonia complicated with rhabdomyolysis was poor in case of a delayed treatment. Early diagnosis would help reduce the mortality.
分析肺炎合并横纹肌溶解症的临床特征及诊断与治疗。我们报告了1例肺炎合并横纹肌溶解症的病例。通过在PubMed数据库中以“鹦鹉热”或“i”以及“横纹肌溶解症”为关键词进行检索（时间范围：1967年1月1日至2020年5月30日），对1978年1月至2020年5月发表的报告进行了文献综述。我们的患者是一名64岁男性，表现为高热、乏力、肌痛和呼吸困难。胸部计算机断层扫描显示双侧肺炎，在疾病进展过程中进一步合并横纹肌溶解症。这促使进行宏基因组下一代测序，在支气管肺泡灌洗液和血液中均发现了序列。在我们检索到的3篇文献报告中的11例病例中，5例合并横纹肌溶解症（其中2例没有完整的临床信息），另外6例患有肌炎且肌酸磷酸激酶水平升高。这产生了3例有完整临床信息供我们分析的病例。我们将他们的信息与我们研究地点管理的单个病例的信息相结合。其中2例为男性，另外2例为女性。患者年龄分别为66岁、46岁、44岁和64岁。所有病例均有发热，3例有活禽接触史。2例有肌痛并迅速进展为呼吸衰竭，另外2例未出现肌痛，经及时治疗后明显好转。所有4例经适当抗生素治疗后均治愈出院。未观察到不良结局。肺炎合并横纹肌溶解症若治疗延迟预后较差。早期诊断有助于降低死亡率。
