Lu Yinyun, Gai Wei, Li Minghui, Zheng Yafeng, Zhang Xiaojing, Zhou Yiqing, Zhou Jie, Duan Jinnan, Ruan Yongchun
Department of Infectious Diseases, Shaoxing People's Hospital, Shaoxing, Zhejiang, People's Republic of China.
WillingMed Technology Beijing Co., Ltd, Beijing, People's Republic of China.
Infect Drug Resist. 2024 Dec 11;17:5523-5533. doi: 10.2147/IDR.S482471. eCollection 2024.
Psittacosis is an often-neglected cause of community acquired pneumonia (CAP). The limited diagnostic methods for psittacosis pneumonia invariably result in an unfavourable prognosis. Consequently, the early detection of psittacosis pneumonia is crucial. This study aimed to analyse the characteristics, clinical features and treatments of the patients to improve early diagnosis and outcomes.
We retrospectively analyzed the clinical features and outcomes of 52 cases of psittacosis pneumonia diagnosed with next-generation sequencing (NGS) from January 2022 to August 2024 in a local tertiary hospital in China.
Of the 52 patients, 18 had a clear exposure to poultry or birds. The main clinical manifestations included fever (100%, 52/52), cough (75.0%, 39/52), fatigue (57.7%, 30/352), and dyspnea (36.5%, 19/52). Significant elevations in neutrophil counts (NEUT), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), D-dimer, lactate dehydrogenase (LDH), creatine kinase (CK), interleukin-6 (IL-6) and interferon-γ (IFN-γ), as well as reductions in lymphocyte (LY) and albumin (ALB) were observed. The main chest computed tomography (CT) features were consolidated. Eight patients diagnosed with severe CAP (SCAP) exhibited higher NEUT, CRP, procalcitonin (PCT), blood urea nitrogen (BUN), creatinine, D-Dimer and IL-6 levels, as well as lower oxygen index. The interval between the onset of symptoms and diagnosis was 6-34 days. infection was identified by metagenomic NGS (mNGS) or targeted NGS (tNGS) in all cases, and the average length of hospital stay for these patients was 9.4 days. Following the identification of the aetiology, all patients were promptly initiated on tetracycline- or fluoroquinolone-based therapy, with complete recovery observed in all cases.
Patients exposed to poultry should be alert to pneumonia. The application of NGS has improved the diagnostic accuracy of pneumonia, reduced unnecessary use of antibiotics, and shortened the course of disease. Patients who received tetracycline-based therapy showed a good prognosis.
鹦鹉热是社区获得性肺炎（CAP）的一个常被忽视的病因。鹦鹉热肺炎的诊断方法有限，这 invariably 导致预后不良。因此，鹦鹉热肺炎的早期检测至关重要。本研究旨在分析患者的特征、临床特点及治疗方法，以改善早期诊断及预后。
我们回顾性分析了2022年1月至2024年8月在中国一家当地三级医院通过下一代测序（NGS）诊断为鹦鹉热肺炎的52例患者的临床特征及预后。
52例患者中，18例有明确的家禽或鸟类接触史。主要临床表现包括发热（100%，52/52）、咳嗽（75.0%，39/52）、乏力（57.7%，30/52）及呼吸困难（36.5%，19/52）。观察到中性粒细胞计数（NEUT）、C反应蛋白（CRP）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、D-二聚体、乳酸脱氢酶（LDH）、肌酸激酶（CK）、白细胞介素-6（IL-6）和干扰素-γ（IFN-γ）显著升高，以及淋巴细胞（LY）和白蛋白（ALB）降低。主要胸部计算机断层扫描（CT）特征为实变。8例诊断为重症CAP（SCAP）的患者表现出更高的NEUT、CRP、降钙素原（PCT）、血尿素氮（BUN）、肌酐、D-二聚体和IL-6水平，以及更低的氧合指数。症状出现至诊断的间隔时间为6至34天。所有病例均通过宏基因组NGS（mNGS）或靶向NGS（tNGS）鉴定出感染，这些患者的平均住院时间为9.4天。在确定病因后，所有患者均立即开始基于四环素或氟喹诺酮的治疗，所有病例均观察到完全康复。
接触家禽的患者应警惕肺炎。NGS的应用提高了肺炎的诊断准确性，减少了抗生素的不必要使用，并缩短了病程。接受基于四环素治疗的患者预后良好。
