鹦鹉热衣原体肺炎5例的临床特点和治疗  

Clinical characteristics and treatment of 5 cases of Chlamydia psittaci pneumonia

作　　者：符韦维 朱永红[2] FU Wei-wei;ZHU Yong-hong(不详;Department of Pharmacy,The Fourth People's Hospital of Rudong County,Nantong,Jiangsu 226400,China)

机构地区：[1]如东县第四人民医院药剂科,江苏南通226400 [2]南通大学附属医院药学部,江苏南通226001

出　　处：《中国临床研究》2022年第8期1115-1119,共5页Chinese Journal of Clinical Research

摘　　要：目的 分析鹦鹉热衣原体肺炎的临床特点和诊疗方案,提高对本病的认识,为鹦鹉热衣原体肺炎的诊治提供参考。方法 选择2019年6月至2021年1月南通大学附属医院确诊、临床药师参与的5例鹦鹉热衣原体肺炎患者的临床资料进行回顾性分析,总结鹦鹉热衣原体肺炎的临床特点和诊治要点。结果 4例患者有鸟类或家禽接触史。5例患者均有发热、咳嗽、乏力的症状。5例患者的白细胞计数正常或轻度升高,C-反应蛋白和红细胞沉降率均升高,Na~+浓度偏低,肝肾功能均正常。5例患者的胸部CT表现为单侧肺或双肺炎症渗出和实变,左肺3例,右肺1例,双侧肺1例,胸腔积液5例。宏基因组二代测序(mNGS)技术检测鹦鹉热衣原体确诊后,4例加用米诺环素,1例单用莫西沙星。5例患者均治疗好转后出院。临床药师参与会诊2例,药学查房3例。结论 鸟类或家禽接触史是鹦鹉热衣原体感染的危险因素。鹦鹉热衣原体感染后无特异性的临床表现、实验室检查和影像学检查。应用mNGS有助于提高鹦鹉热衣原体肺炎诊断的准确性和及时性。四环素类药物对鹦鹉热衣原体肺炎疗效明显。Objective To analyze the clinical features, diagnosis and treatment of patients with Chlamydia psittaci pneumonia to provide reference for clinical diagnosis and treatment of it. Methods The clinical data of 5 patients with Chlamydia psittaci pneumonia diagnosed in the affiliated Hospital of Nantong University from June 2019 to January 2021 were retrospectively analyzed to study its clinical characteristics, diagnosis and treatment. Results There was a history of contact with birds or poultry in 4 patients. The symptoms in 5 patients were fever, cough and fatigue. White blood cell count was normal or slightly elevated, and C-reactive protein level and erythrocyte sedimentation rate increased, with low Naconcentration and normal liver and kidney function in 5 cases. Chest CT showed inflammatory exudation and unilateral or bilateral pulmonary consolidation, including 3 cases of left lung, 1 case of right lung, 1 case of bilateral lung and pleural effusion in 5 cases. After Chlamydia psittaci was confirmed by metagenomics next-generation sequencing(mNGS), minocycline was added in 4 cases, and moxifloxacin alone was used in 1 case. All patients were discharged after treatment. Clinical pharmacists participated in consultation in 2 cases, with pharmaceutical ward rounds in 3 cases. Conclusions The history of contact with birds or poultry is a risk factor for Chlamydia psittaci infection. There is no specific clinical manifestation, laboratory examination and imaging examination after Chlamydia psittaci infection. The application of mNGS is helpful to improve the accuracy and timeliness of diagnosis of Chlamydia psittaci pneumonia. Tetracyclines are effective antibiotics for the treatment of Chlamydia psittaci pneumonia.

关 键 词：鹦鹉热衣原体 肺炎 宏基因组二代测序 临床药师 

分 类 号：R518.1[医药卫生—内科学] R978[医药卫生—临床医学]