Zhang Shumeng, Fu Yiqi, Fang Liangjie, Xu Qiaomai, Gu Silan, Zhou Hua, Zhou Jianying
Department of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
BMC Infect Dis. 2025 May 17;25(1):717. doi: 10.1186/s12879-025-11081-4.
Chlamydia psittaci is a rare pathogen that causes community-acquired pneumonia. The reversed halo sign (RHS) is a computed tomography (CT) finding that is commonly observed in diseases such as cryptogenic organizing pneumonia, invasive fungal infections, tuberculosis, sarcoidosis, and pulmonary thromboembolism, but has seldom been described in association with psittacosis pneumonia.
We report a case in which a 26-year-old man with a history of close contact with pigeons and chicken manure presented with fever and cough for 6 days. A CT examination revealed the RHS in the right lower lobe of the lung. Psittacosis pneumonia was diagnosed by metagenomic next-generation sequencing of the patient's bronchoalveolar lavage fluid. Treatment with omadacycline abolished his symptoms. We also discuss six other cases of psittacosis pneumonia with the RHS identified by literature search.
When clinicians encounter patients with atypical pneumonia with the RHS and a history of contact with poultry, psittacosis should be considered.
鹦鹉热衣原体是一种引起社区获得性肺炎的罕见病原体。反晕征（RHS）是一种在计算机断层扫描（CT）中发现的征象，常见于隐源性机化性肺炎、侵袭性真菌感染、肺结核、结节病和肺血栓栓塞等疾病中，但很少与鹦鹉热肺炎相关联。
我们报告一例病例，一名26岁有与鸽子和鸡粪密切接触史的男性，出现发热和咳嗽6天。CT检查显示右肺下叶有反晕征。通过对患者支气管肺泡灌洗液进行宏基因组下一代测序诊断为鹦鹉热肺炎。使用奥马环素治疗后症状消失。我们还通过文献检索讨论了另外6例有反晕征的鹦鹉热肺炎病例。
当临床医生遇到有反晕征且有家禽接触史的非典型肺炎患者时，应考虑鹦鹉热。
