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以听力丧失为首发症状的鹦鹉热衣原体肺炎 1 例报告并文献复习

Hearing loss as the first symptom of pneumonia caused by Chlamydia psittaci: a case report and literature review.

机构信息

Department of Pulmonary and Critical Care Medicine, Dongyang Hospital Affiliated to Wenzhou Medical University, Dongyang, Zhejiang Province, China.

出版信息

BMC Infect Dis. 2024 Nov 18;24(1):1314. doi: 10.1186/s12879-024-10210-9.

Abstract

BACKGROUND

The typical clinical symptoms of psittacosis pneumonia include fever, dry cough, and chills. Sudden sensorineural hearing loss is a relatively uncommon condition in pneumonia caused by Chlamydia psittaci. In this study, we reported a rare case of Chlamydia psittaci pneumonia presented as hearing loss.

CASE PRESENTATION

A 65-year-old man presented to our hospital with sudden hearing loss, cough with sputum, and fever for the last three days. Chest computed tomography revealed inflammation of the left lung and poor response to broad-spectrum antibiotics. The metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid identified the sequence of Chlamydia psittaci. Subsequently, antibiotic treatment was adjusted to doxycycline hydrochloride and moxifloxacin, resulting in significant improvement in both hearing loss and lung infection.

CONCLUSIONS

Sudden sensorineural hearing loss as an extrapulmonary feature of Chlamydia psittaci pneumonia is extremely rare. Although the exact mechanism remains unclear, this case report described a patient with sudden bilateral sensorineural hearing loss as a presenting feature of Chlamydia psittaci pneumonia, illustrating the importance of the extrapulmonary features of atypical pneumonia. The mNGS test could provide early diagnosis. Many patients had a good prognosis with prompt and effective treatment.

摘要

背景

鹦鹉热肺炎的典型临床症状包括发热、干咳和寒战。突发性感觉神经性听力损失是鹦鹉热衣原体引起的肺炎中相对罕见的情况。在本研究中,我们报告了一例以听力损失为表现的罕见鹦鹉热衣原体肺炎病例。

病例介绍

一名 65 岁男性因突发性听力丧失、咳嗽伴咳痰和发热三天就诊于我院。胸部 CT 显示左肺炎症,广谱抗生素治疗反应不佳。支气管肺泡灌洗液的宏基因组下一代测序(mNGS)鉴定出鹦鹉热衣原体序列。随后,抗生素治疗调整为盐酸多西环素和莫西沙星,听力损失和肺部感染均显著改善。

结论

突发性感觉神经性听力损失作为鹦鹉热衣原体肺炎的肺外表现极为罕见。尽管确切机制尚不清楚,但本病例报告描述了一例以突发性双侧感觉神经性听力损失为表现的鹦鹉热衣原体肺炎患者,说明了非典型肺炎肺外表现的重要性。mNGS 检测可提供早期诊断。许多患者在及时有效的治疗后预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fae/11571506/0c5a0c28c905/12879_2024_10210_Fig1_HTML.jpg

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