Yang Na, Ou Zhengqiu, Sun Qian, Pan Junping, Wu Jing, Xue Chen
Department of Radiology, Chengdu Fifth People's Hospital, Chengdu, 611130, China.
Department of Radiology, People's Hospital of Ningxiang, Changsha, 410600, China.
BMC Infect Dis. 2025 Jan 2;25(1):11. doi: 10.1186/s12879-024-10374-4.
To present the different findings of Chlamydia psittaci (C. psittaci) pneumonia on computed tomography (CT) according to the progression of the disease, to improve diagnostic accuracy, guide early clinical diagnosis, evaluate treatment efficacy, and reduce the mortality associated with the disease.
In total, 80 cases of C. psittaci pneumonia diagnosed through next-generation sequencing from January 2019 to December 2023 in multiple hospitals in China were collected according to the inclusion criteria and analyzed. The study discussed important CT findings and their dynamic changes.
The most common manifestations of C. psittaci pneumonia are lobar pneumonia and spherical pneumonia types with interstitial changes. The most common signs are the intralobular lines, air bronchogram sign, and reverse halo sign. In addition, necrosis, cavitation, and the tree-in-bud sign are rare but often associated with pleural effusion and splenomegaly. In the ultra-early stage, vascular inflammation changes were observed on imaging, often manifesting as ground-glass opacities around small core vessels or thickening of pulmonary hilar vessels. In the early stage, secondary lobules showed high-density shadows, which rapidly fused into large areas in the progressive stage, easily forming lobar pneumonia. The repair and absorption period tended to show the formation of the reverse halo sign centrally, and the dissipation period might have led to the formation of fibrous bands.
Combining clinical manifestations, laboratory tests, contact history, and imaging findings contribute to the diagnosis of C. psittaci pneumonia.
根据疾病进展情况呈现鹦鹉热衣原体（C. psittaci）肺炎在计算机断层扫描（CT）上的不同表现，以提高诊断准确性，指导早期临床诊断，评估治疗效果，并降低该疾病相关的死亡率。
根据纳入标准收集了2019年1月至2023年12月在中国多家医院通过下一代测序诊断的80例鹦鹉热衣原体肺炎病例并进行分析。该研究讨论了重要的CT表现及其动态变化。
鹦鹉热衣原体肺炎最常见的表现为伴有间质改变的大叶性肺炎和球形肺炎类型。最常见的征象为小叶内条索影、空气支气管征和反晕征。此外，坏死、空洞形成和树芽征少见，但常伴有胸腔积液和脾肿大。在超早期，影像学上观察到血管炎症改变，常表现为小核心血管周围的磨玻璃影或肺门血管增粗。在早期，次级肺小叶出现高密度影，在进展期迅速融合成大片状，易形成大叶性肺炎。修复吸收期倾向于在中央出现反晕征，消散期可能导致纤维条索形成。
结合临床表现、实验室检查、接触史和影像学表现有助于鹦鹉热衣原体肺炎的诊断。
