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[鸟疫暴发期间出现肺炎球菌样表现的重症肺炎]

[Severe pneumonia with a pneumococcal aspect during an ornithosis outbreak].

作者信息

Goupil F, Pellé-Duporté D, Kouyoumdjian S, Carbonnelle B, Tuchais E

机构信息

Service de Pneumologie, CHU d'Angers.

出版信息

Presse Med. 1998 Jun 20;27(22):1084-8.

PMID:9767806
Abstract

OBJECTIVES

To describe the clinical, radiological and biological features of Chlamydia psittaci pneumonia.

METHODS

A pneumonia outbreak occurred in a healthy middle-aged population working in a poultry slaughterhouse. Systematic serology (2 samples at 5 weeks intervals) provided the diagnosis of Chlamydia psittaci pneumonia in 6 patients. Patient files were analyzed retrospectively.

RESULTS

The clinical presentations in this series of pneumonia were particularly homogeneous with a pneumococcal profile in all 6 cases: sudden onset, temperature above 39 degrees C, lobar alveolar involvement, hypoxemia, hyperleukocytosis and liver dysfunction. One case of hallucinatory delirium was observed. The patients were given spiramycin (9 million units per day for 3 weeks) and all recovered rapidly with no complications.

CONCLUSION

The unusual virulence of the Chlamydia psittaci and very important inoculum were probably involved in this outbreak because of the severity of the pulmonary features and the short exposure of some patients to the bacteria. These cases suggest that the prevention of ornithosis in poultry slaughterhouses should be reinforced.

摘要

目的

描述鹦鹉热衣原体肺炎的临床、放射学和生物学特征。

方法

在一家家禽屠宰场工作的健康中年人群中发生了肺炎疫情。系统血清学检查(间隔5周采集2份样本)确诊了6例鹦鹉热衣原体肺炎患者。对患者病历进行回顾性分析。

结果

这一系列肺炎的临床表现特别一致,所有6例均具有肺炎球菌特征:起病急,体温高于39摄氏度,大叶肺泡受累,低氧血症,白细胞增多和肝功能障碍。观察到1例幻觉谵妄。患者接受了螺旋霉素治疗(每天900万单位,持续3周),所有患者均迅速康复,无并发症。

结论

由于肺部症状严重且部分患者接触细菌的时间短,鹦鹉热衣原体异常的毒力和非常大量的接种物可能与此次疫情有关。这些病例表明,应加强家禽屠宰场中鸟疫的预防。

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