Song Lan, Liang Qiumei, Chen Yanqiong, Wu Liyun, Zhou Jianpeng, Wei Zuyou, Xie Jiayi, Liu Hang, Meng Jianfeng
Guangxi University of Chinese Medicine, Nanning 530219, China.
Department of Respiratory and Critical Care Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region(Joint Training Base of Guangxi University of Chinese Medicine), Nanning 530021, China.
Diagn Microbiol Infect Dis. 2025 Nov;113(3):116985. doi: 10.1016/j.diagmicrobio.2025.116985. Epub 2025 Jun 28.
To investigate the clinical features, diagnostic approaches, and therapeutic strategies for Chlamydia psittaci (C. psittaci) pneumonia.
We conducted a retrospective analysis of 14 patients diagnosed with C. psittaci pneumonia between December 2021 and February 2025 at The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China. Diagnosis was confirmed via metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF). Clinical manifestations, laboratory findings, imaging characteristics, treatment regimens, and outcomes were systematically analyzed.
The cohort comprised seven males and seven females, aged 46-83 years. A documented history of avian exposure was present in 57.1 % (8/14) of patients. All patients presented with high fever. Lab tests showed increased inflammatory markers (CRP, ESR, d-dimer) in all patients. White blood cell counts were elevated in seven patients and normal in seven others. Neutrophilia occurred in 11 cases and lymphopenia in 13. Elevated procalcitonin (10 cases), LDH (12 cases), creatine kinase (8 cases), and transaminases (ALT: 7 cases; AST: 9 cases) were documented. Electrolyte disturbances included hypokalemia (6 cases), hyponatremia (9 cases), and hypochloremia(13 cases). Eight patients had renal dysfunction (high creatinine/urea), six showed hyperbilirubinemia. Chest imaging revealed varied lung infiltrations: consolidations, ground-glass opacities, nodular shadows, and patchy infiltrates. All cases were confirmed by mNGS and effectively treated with tetracyclines or fluoroquinolones.
C. psittaci pneumonia frequently presents with sepsis-like symptoms and rapid clinical deterioration. Early diagnosis using mNGS is crucial for guiding timely antimicrobial therapy, significantly improving patient outcomes, especially in cases where conventional diagnostics may be limited or delayed.
探讨鹦鹉热衣原体（C. psittaci）肺炎的临床特征、诊断方法及治疗策略。
对2021年12月至2025年2月期间在中国广西壮族自治区南宁市人民医院确诊为C. psittaci肺炎的14例患者进行回顾性分析。通过支气管肺泡灌洗液（BALF）的宏基因组下一代测序（mNGS）确诊。系统分析临床表现、实验室检查结果、影像学特征、治疗方案及预后。
该队列包括7名男性和7名女性，年龄在46 - 83岁之间。57.1%（8/14）的患者有明确的禽类接触史。所有患者均出现高热。实验室检查显示所有患者炎症指标（CRP、ESR、D - 二聚体）升高。7例患者白细胞计数升高，7例正常。11例出现中性粒细胞增多，13例出现淋巴细胞减少。记录到降钙素原升高（10例）、乳酸脱氢酶升高（12例）、肌酸激酶升高（8例）及转氨酶升高（ALT：7例；AST：9例）。电解质紊乱包括低钾血症（6例）、低钠血症（9例）和低氯血症（13例）。8例患者出现肾功能不全（肌酐/尿素升高），6例出现高胆红素血症。胸部影像学显示肺部浸润多样：实变、磨玻璃影、结节影及斑片状浸润。所有病例均经mNGS确诊，并接受四环素或氟喹诺酮类药物有效治疗。
C. psittaci肺炎常表现为类似败血症的症状且临床病情迅速恶化。使用mNGS进行早期诊断对于指导及时的抗菌治疗至关重要，可显著改善患者预后，尤其是在传统诊断可能受限或延迟的情况下。
