Xiao Qiang, Shen Wei, Zou Yeqiang, Dong Susu, Tan Yafen, Zhang Xuan, Yao Lu, Li Qiuping, Pei Wenjun, Wang Tianli
Department of Respiratory Medicine, The First People's Hospital of Changde City, Hunan, PR China.
Department of Outpatient, The First People's Hospital of Changde City, Hunan, PR China.
J Med Microbiol. 2021 Nov;70(11). doi: 10.1099/jmm.0.001456.
is an important cause of community-acquired pneumonia (CAP). The spectrum of CAP due to ranges from mild, self-limited to acute respiratory failure and the early identification of this disease can be challenging. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid has the potential to improve the pathogen identification in severe CAP. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid has the potential to rapidly identify pathogens in severe CAP. The early identification and appropriate use of antibiotics can improve the prognosis of severe CAP caused by . The aim of the study is to describe the clinical spectrum of severe psittacosis pneumonia to provide a better understanding of this disease and to demonstrate that mNGS is an effective method for pathogen detection. Retrospective case analysis from November 2019 to November 2020 was performed. Sixteen cases of severe psittacosis pneumonia were diagnosed through mNGS. Clinical features, laboratory findings, imaging features, treatment and outcome were summarized. Frequent symptoms included fever (16/16, 100%), dyspnoea (16/16, 100%), cough (12/16, 75%), sputum (11/16, 69%) and headache (9/16, 56%). The median leukocytosis was within the normal range, while C-reactive proteins, CK, LDH, AST, D-Dimer were significantly elevated. The feature of computed tomography included ground-glass opacity with consolidation and multiple lobar distributions. The total number of sequences of identified from bronchoalveolar lavage by mNGS varied from 58 to 57115. Five patients underwent noninvasive mechanical ventilation, four patients underwent high flow humidified oxygen therapy and one patient underwent invasive mechanical ventilation. Two patients had septic shock needing vasoactive medications. All of the sixteen patients experienced full recoveries.. The symptoms of severe CAP caused by were not typical while laboratory results may have some clues. The mNGS technology can early detect of psittacosis, reduce unnecessary use of antibiotics and short the course of the disease.
是社区获得性肺炎（CAP）的重要病因。由其引起的CAP范围从轻度、自限性到急性呼吸衰竭，而该疾病的早期识别可能具有挑战性。支气管肺泡灌洗液体的宏基因组下一代测序（mNGS）有潜力改善重症CAP中的病原体识别。支气管肺泡灌洗液体的宏基因组下一代测序（mNGS）有潜力在重症CAP中快速识别病原体。早期识别并合理使用抗生素可改善由其引起的重症CAP的预后。本研究的目的是描述重症鹦鹉热肺炎的临床特征，以更好地了解该疾病，并证明mNGS是一种有效的病原体检测方法。进行了2019年11月至2020年11月的回顾性病例分析。通过mNGS诊断出16例重症鹦鹉热肺炎。总结了临床特征、实验室检查结果、影像学特征、治疗及转归。常见症状包括发热（16/16，100%）、呼吸困难（16/16，100%）、咳嗽（12/16，75%）、咳痰（11/16，69%）和头痛（9/16，56%）。白细胞增多的中位数在正常范围内，而C反应蛋白、肌酸激酶、乳酸脱氢酶、天门冬氨酸氨基转移酶、D-二聚体显著升高。计算机断层扫描特征包括磨玻璃影伴实变及多叶分布。通过mNGS从支气管肺泡灌洗中鉴定出的序列总数从58到57115不等。5例患者接受无创机械通气，4例患者接受高流量湿化氧疗，1例患者接受创机械通气。2例患者发生感染性休克，需要血管活性药物治疗。16例患者均完全康复。由其引起的重症CAP症状不典型，而实验室结果可能有一些线索。mNGS技术可早期检测鹦鹉热，减少抗生素的不必要使用并缩短病程。
