家庭聚集性鹦鹉热的临床特征及诊断分析  

Analysis of clinical features and diagnosis of familial aggregation psittacosis

作　　者：孙蕊芸 牟丹蕾[1] 李娟[1] 吉杉 高丽娟 张佳莹[1] 梁连春[1] Sun Ruiyun;Mou Danlei;Li Juan;Ji Shan;Gao Lijuan;Zhang Jiaying;Liang Lianchun(General Department of Infection,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院感染综合科,100069

出　　处：《北京医学》2022年第10期902-906,共5页Beijing Medical Journal

摘　　要：目的探讨饲养鹦鹉引起家庭聚集性鹦鹉热的临床特征及诊断方法。方法选取2021年5月至2022年5月首都医科大学附属北京佑安医院收治的鹦鹉热患者6例,回顾性分析患者的临床资料、实验室检查、胸部CT、治疗方案和随访结果。结果6例患者来自2个家庭,均有病/死鹦鹉接触史,平均接触(21.5±4.1)d后急性起病,表现为发热(100.0%,6例)、乏力(83.3%,5例)、肌肉酸痛(66.7%,4例)、咽痛(66.7%,4例)、咳嗽(66.7%,4例)、头痛(33.3%,2例)、呕吐(33.3%,2例)、畏寒(33.3%,2例)等症状,患者均无呼吸困难。6例(100.0%)患者WBC、Hb和PLT均正常,4例(66.7%)患者CRP明显升高,3例(50.0%)患者转氨酶轻度升高。6例(100.0%)患者胸部CT均以斑片状阴影或团片状实变影为特征。经宏基因组二代测序(metagenomic next-generation sequencing,mNGS)诊断为鹦鹉热。患者接受多西环素或阿奇霉素治疗,平均退热时间(2.2±0.7)d,平均住院时间(4.7±1.6)d,随访肺部CT病灶缩小或消失。结论饲养鹦鹉可能导致家庭聚集性鹦鹉热,患者表现为流感样症状,肺部CT以片状实变影为特点,mNGS有助于确诊。Objective To explore the clinical features and diagnosis of psittacosis caused by keeping parrots.Methods A total of six patients with psittacosis admitted to Beijing Youan Hospital,Capital Medical University from May 2021 to May 2022 were selected.The clinical information,laboratory examination results,chest CT scans,treatment options and follow-up results of the patients were retrospectively analyzed.Results Six patients from two families all had contact history with sick or dead parrots.After the average contact time(21.5±4.1)d the disease attacked the patients.The clinical manifestations were fever(100.0%,six cases),fatigue(83.3%,five cases),muscle soreness(66.7%,four cases),sore throat(66.7%,four cases),cough(66.7%,four cases),headache(33.3%,two cases),vomiting(33.3%,two cases),chills(33.3%,two cases).No patients had dyspnea.Laboratory tests showed six cases(100.0%)with normal WBC,Hb and PLT results,four cases(66.7%)with significantly increased CRP and three cases(50.0%)with slightly increased transaminase.Chest CT scans of six cases(100.0%)were characterized by patchy shadowing or consolidation.Psitsitosis was diagnosed by metagenomic nextgeneration sequencing(mNGS).Six patients received treatment of doxycycline or azithromycin.The average antipyretic time was(2.2±0.7)d,and the average length hospital stay was(4.7±1.6)d.The lesions of Chest CT scans shrank or disappeared during the follow-up.Conclusions Raising parrots can lead to familial aggregation psittacosis.The clinical manifestations of psittacosis are mainly flu-like symptoms,and the chest CT scans is characterized by patchy shadowing or consolidation.mNGS is helpful for the diagnosis of psittacosis.

关 键 词：鹦鹉热 宏基因组二代测序 家庭聚集性 临床特征 诊断 

分 类 号：R518.1[医药卫生—内科学]