摘要
Abstract
Two patients had a history of pigeon contact and presented with fever,fatigue and dyspnea.One patient devel-oped acute respiratory distress syndrome(ARDS)on the fourth day of the disease and required non-invasive ventilator as-sisted ventilation.Leukocyte count was slightly increased in 2 patients,lymphocyte percentage was decreased,platelet count was normal,procalcitonin was increased,C-reactive protein was significantly increased,alanine aminotransferase and as-partate aminotransferase were increased to varying degrees,serum sodium,potassium and albumin were decreased,erythro-cyte sedimentation rate(ESR)was normal in 1 patient and slightly increased in 1 patient.The pathogen could not be identi-fied by routine culture and serological examination of blood and alveolar lavage fluid.Chest X-ray,computed tomography(CT)showed large exudation and consolidation of one lung lobe,rapid progression in severe cases,involving both lung lobes,respiratory failure,and poor effect of empirical antibiotic use.After timely application of metagenomic next-generation se-quencing(mNGS)technology combined with avian contact history,the patient was finally diagnosed with Chlamydia psittaci pneumonia.After treatment with quinolones combined with tetracycline antibiotics,the symptoms,signs and imaging abnor-malities of the patient were significantly improved,but 1 patient had poor imaging absorption and was further treated with macrolide antibiotics for 1 week.Follow-up examination of chest CT showed that the lesion was basically absorbed.By ana-lyzing the clinical characteristics,diagnosis and treatment process of these two patients,it can provide reference for clinical diagnosis and treatment of these diseases.关键词
重症肺炎/鹦鹉热衣原体/宏基因组二代测序/肝损害Key words
Severe pneumonia/Chlamydia psittaci/Metagenomic next-generation sequencing/Hepatic damage分类
医药卫生
