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由……引起的急性呼吸窘迫综合征:一例报告及文献综述

Acute respiratory distress syndrome caused by : a case report and literature review.

作者信息

Zhou Yan, Zou Ya, Zhou Lu, Wei Hua, Zou Yong-Wei, Guo Xi-Rui, Ye Yong-Qin, Li Na, Lu Yun

机构信息

Department of Pharmacy, Chengdu Second People's Hospital, Chengdu, Sichuan, China.

Department of Respiratory and Critical Care Medicine, Chengdu Second People's Hospital, Chengdu, Sichuan, China.

出版信息

Front Med (Lausanne). 2024 Dec 3;11:1418241. doi: 10.3389/fmed.2024.1418241. eCollection 2024.

Abstract

BACKGROUND

Psittacosis is a zoonotic disease with a low incidence rate and a lack of specificity in clinical manifestations, making it prone to be missed, misdiagnosed, and even cause delayed treatment for patients. Metagenomic next-generation sequencing (mNGS) was successfully performed for the diagnosis of a young patient with psittacosis progressing to acute respiratory distress syndrome (ARDS), and precisely targeted antibiotic treatment was promptly administered. Additionally, a comprehensive review was conducted on 68 cases of psittacosis complicated with ARDS, with the goal of improving the clinical awareness of this disease.

CASE PRESENTATION

This study reports a 37-year-old young female who was infected with () after contact with parrots and eventually developed ARDS. The patient initially developed fever and sore throat, followed by cough and expectoration. Despite receiving empirical anti-infection treatment, the condition continued to progress rapidly, and severe dyspnea developed within a short period of time. She was subsequently transferred to the intensive care unit (ICU) and underwent tracheal intubation and mechanical ventilation due to acute respiratory failure. After the DNA sequence of in bronchoalveolar lavage fluid (BALF) was detected through mNGS, the patient received targeted antibiotic treatment with doxycycline and moxifloxacin, and her clinical symptoms gradually improved.

CONCLUSION

Epidemiological investigations and the application of mNGS are crucial for the early identification and diagnosis of psittacosis. For suspected psittacosis patients, the application of mNGS technology could promote early identification of pathogens and targeted antimicrobial therapy, which might improve patient prognosis. In addition, young psittacosis patients without underlying disease should also be vigilant about the possibility of developing severe cases.

摘要

背景

鹦鹉热是一种人畜共患病,发病率低,临床表现缺乏特异性,容易漏诊、误诊,甚至导致患者延误治疗。对一名进展为急性呼吸窘迫综合征(ARDS)的鹦鹉热年轻患者成功进行了宏基因组下一代测序(mNGS)诊断,并及时给予了精准的靶向抗生素治疗。此外,对68例鹦鹉热合并ARDS病例进行了综合回顾,旨在提高对该疾病的临床认识。

病例介绍

本研究报告了一名37岁的年轻女性,在接触鹦鹉后感染(),最终发展为ARDS。患者最初出现发热和咽痛,随后出现咳嗽和咳痰。尽管接受了经验性抗感染治疗,但病情仍迅速进展,短期内出现严重呼吸困难。随后她被转入重症监护病房(ICU),因急性呼吸衰竭接受了气管插管和机械通气。通过mNGS检测支气管肺泡灌洗液(BALF)中的DNA序列后,患者接受了多西环素和莫西沙星的靶向抗生素治疗,临床症状逐渐改善。

结论

流行病学调查和mNGS的应用对鹦鹉热的早期识别和诊断至关重要。对于疑似鹦鹉热患者,应用mNGS技术可促进病原体的早期识别和靶向抗菌治疗,可能改善患者预后。此外,无基础疾病的年轻鹦鹉热患者也应警惕发展为重症的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f69/11653191/40332554fcf2/fmed-11-1418241-g001.jpg

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