Department of Imaging, Yueyang Central Hospital, Yueyang, Hunan, China.
Department of Pulmonary and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
Clin Respir J. 2022 Jul;16(7):513-521. doi: 10.1111/crj.13519. Epub 2022 Jun 20.
The aim of this study was to investigate the clinical characteristics of Chlamydia psittaci pneumonia and evaluate the diagnostic value of Metagenomic Next-Generation Sequencing (mNGS). A total of 44 patients diagnosed with Chlamydia psittaci pneumonia using mNGS were retrospectively analysed. The demographic and clinical features, laboratory data, imaging findings and clinical outcomes were collected. Results showed that 65.91% of the patients had a history of exposure to poultry or birds. All patients presented with fever. Apart from systemic and respiratory symptoms, some patients also presented with digestive and neurological symptoms. Respiratory failure was common among patients. The key laboratory tests were normal white blood cell counts, slightly elevated PCT, changes in levels of cardiac enzymes, liver enzymes and hyponatremia. Chest imaging revealed that most of the lesions contained patchy exudation or lobar consolidation of one lobe, especially in the lower lobe. Consolidation of both lungs was seen in critically ill patients. Although quinolones were effective in most patients, tetracyclines should be the first choice of treatment. The overall prognosis was good; however, patients who developed severe pneumonia had poor prognosis. The incidence of chlamydia psittaci pneumonia may be underestimated due to the nonspecific clinical manifestations and lack of confirmatory testing methods. The use of mNGS has increased the number of patients diagnosed with chlamydia psittaci pneumonia. mNGS is an effective diagnostic method for chlamydia psittaci pneumonia.
本研究旨在探讨鹦鹉热衣原体肺炎的临床特征,并评估宏基因组下一代测序(mNGS)的诊断价值。回顾性分析了 44 例经 mNGS 诊断为鹦鹉热衣原体肺炎的患者。收集了患者的人口统计学和临床特征、实验室数据、影像学表现和临床结局。结果显示,65.91%的患者有接触家禽或鸟类的病史。所有患者均有发热。除全身和呼吸系统症状外,部分患者还出现消化系统和神经系统症状。呼吸衰竭在患者中较为常见。关键实验室检查为白细胞计数正常、降钙素原轻度升高、心肌酶、肝酶和低钠血症改变。胸部影像学显示,大部分病变为单侧斑片状渗出或肺叶实变,以下叶多见。重症患者两肺均见实变。虽然大多数患者对喹诺酮类药物有效,但四环素类药物应作为首选治疗药物。总体预后良好;然而,发生重症肺炎的患者预后较差。由于临床表现非特异性且缺乏确证性检测方法,鹦鹉热衣原体肺炎的发病率可能被低估。mNGS 的应用增加了鹦鹉热衣原体肺炎的诊断病例数。mNGS 是一种有效的鹦鹉热衣原体肺炎诊断方法。