Chen Jiamei, Wang Jin, Deng Ziwei, Li Yongzhong, Liu Yuni, Zhou Jianliang
Department of Infectious Diseases, Hunan University of Medicine General Hospital, Huaihua, Hunan Province, People's Republic of China.
Department of Clinical Pharmacy Group, Hunan University of Medicine General Hospital, Huaihua, Hunan Province, People's Republic of China.
Infect Drug Resist. 2024 Dec 21;17:5775-5784. doi: 10.2147/IDR.S493927. eCollection 2024.
Our objective was to analyze the clinical and imaging features of pneumonia to enhance its diagnostic accuracy.
We systematically reviewed the cases of Chlamydia psittaci diagnosed by next-generation sequencing at the Hunan University of Medicine General Hospital between March 2019 and June 2024, summarizing and analyzing their clinical characteristics and imaging features.
A total of 50 cases that met the inclusion criteria were ultimately included in the study analysis. The median age of the patients was 62.96±11.08 years. Notably, 46 patients (92%) had potential exposure to birds or poultry. Forty-six patients (92%) temperature ≥39.0 °C, 37 patients (74%) had cough, 34 patients (68%) had moist rale, and 39 patients (78%) had a relatively slow pulse. Laboratory tests indicated that over 70% of patients exhibited elevated infection markers, accompanied by abnormalities in liver and renal function, electrolyte levels, and cardiac enzymes. Meanwhile, the patient's white blood cell count was normal. Chest CT (Computed Tomography) frequently revealed flaky shadows (94%), thoracic effusions (68%), and thickened pleura (54%). Bronchoscopy revealed significant bronchial mucosal hyperemia, swelling (93.478%), and reduced secretion (56.522%). A total of 44 patients (88%) showed a gradual improvement over 12 days. Forty patients (80%) were treated with doxycycline. Fifty patients were classified into two groups according to whether severe pneumonia occurred after admission. WBC (white blood cell), N% (percentage of neutrophils), NLR (Neutrophil-to-lymphocyte ratio), PLR (platelet/lymphocyte ratio), SII (platelet*Neutrophil/lymphocyte ratio), and PCT (procalcitonin) are indicators that suggest severe cases.
The combination of the following indicators is expected to aid in diagnosis of pneumonia: opportunities to come into contact with birds or poultry, high fever, relatively slow pulse, and elevated infection indicators accompanied by organ injury. Treatment with doxycycline was effective and resulted in favorable prognosis.
我们的目的是分析肺炎的临床和影像学特征，以提高其诊断准确性。
我们系统回顾了2019年3月至2024年6月在湖南医药学院附属医院通过下一代测序诊断的鹦鹉热衣原体病例，总结并分析其临床特征和影像学特征。
共有50例符合纳入标准的病例最终纳入研究分析。患者的中位年龄为62.96±11.08岁。值得注意的是，46例患者（92%）有接触鸟类或家禽的潜在暴露史。46例患者（92%）体温≥39.0℃，37例患者（74%）有咳嗽，34例患者（68%）有湿啰音，39例患者（78%）脉搏相对缓慢。实验室检查表明，超过70%的患者感染指标升高，同时伴有肝肾功能、电解质水平和心肌酶异常。与此同时，患者的白细胞计数正常。胸部CT（计算机断层扫描）常显示片状阴影（94%）、胸腔积液（68%）和胸膜增厚（54%）。支气管镜检查显示支气管黏膜明显充血、肿胀（93.478%），分泌物减少（56.522%）。共有44例患者（88%）在12天内逐渐好转。40例患者（80%）接受了多西环素治疗。50例患者根据入院后是否发生重症肺炎分为两组。白细胞（WBC）、中性粒细胞百分比（N%）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、血小板*中性粒细胞/淋巴细胞比值（SII）和降钙素原（PCT）是提示重症病例的指标。
以下指标的组合有望有助于肺炎的诊断：接触鸟类或家禽的机会、高热、相对缓慢的脉搏以及伴有器官损伤的感染指标升高。多西环素治疗有效，预后良好。
