Zheng Xi, Wu Chonghao, Jiang Bing, Qin Guangmei, Zeng Ming
Department of Respiratory and Critical Care Medicine, Yongchuan Hospital Affiliated to Chongqing Medical University, 439 Xuanhua Road, Yongchuan District, Chongqing, 402160, China.
Open Life Sci. 2023 Sep 26;18(1):20220698. doi: 10.1515/biol-2022-0698. eCollection 2023.
The clinical characteristics and diagnosis of ten cases with severe pneumonia were analyzed. Ten patients had high fever, cough, or diarrhea, and all had a history of contact with birds or poultry. The white blood cell count of the patients was normal or slightly increased. The percentage of neutrophils (%) and C reactive protein of the patients were significantly increased. Chest computer tomography showed patchy consolidation of both lungs, with one-sided lung lobes prominent, and bronchial inflation signs. All the patients were admitted to the intensive care unit due to respiratory failure. Nine patients needed ventilator-assisted ventilation therapy, and one patient needed high-flow oxygen therapy. All patients had sepsis, and five patients developed septic shock. The patients were diagnosed with severe pneumonia by clinical manifestations and contact history. After timely adjustment of tetracycline-based treatment, eight patients recovered and were discharged, and two patients died of septic shock and respiratory failure. Patients with poultry contact should be cautious toward pneumonia. A better method for the detection of is metagenomic next-generation sequencing. Its examination can shorten the diagnosis time. In a later stage, large-sample research is needed to guide clinical diagnosis and treatment.
分析了10例重症肺炎患者的临床特征及诊断情况。10例患者均有高热、咳嗽或腹泻症状，且均有接触鸟类或家禽史。患者白细胞计数正常或略有升高。患者中性粒细胞百分比（%）及C反应蛋白显著升高。胸部计算机断层扫描显示双肺斑片状实变，一侧肺叶突出，伴有支气管充气征。所有患者均因呼吸衰竭入住重症监护病房。9例患者需要呼吸机辅助通气治疗，1例患者需要高流量氧疗。所有患者均发生脓毒症，5例患者发生感染性休克。根据临床表现及接触史诊断为重症肺炎。经及时调整以四环素为主的治疗方案后，8例患者康复出院，2例患者死于感染性休克及呼吸衰竭。有家禽接触史的患者应警惕肺炎。宏基因组下一代测序是一种更好的检测方法。其检查可缩短诊断时间。后期需要进行大样本研究以指导临床诊断和治疗。
