贾卫红 1杨雅菲 1孟晔 1郝娜娜 1王丽娜 1卜丽娜 1刘志燕 1唐晶晶1
作者信息
- 1. 710083 西安,西北大学附属医院 西安市第三医院呼吸与危重症医学科
- 折叠
摘要
Abstract
Objective To investigate the clinical characteristics of chlamydia psittaci pneumonia and the causes of delayed diagnosis and treatment.Methods The clinical data of 6 patients developing chlamydia psittaci pneumonia with per-sistent high fever as the main clinical manifestation from January 2022 to December 2023 were analyzed,and the case charac-teristics,diagnosis and treatment process,causes of misdiagnosis and preventive measures were summarized.Results All the 6 patients had acute onset,mainly manifested as persistent high fever with a maximum body temperature of 42.0℃,including 3 patients who had contact history with birds and poultry,and the remaining patients denied contact history with birds and poultry.There was fatigue and dyspnea in 5 patients,anorexia in 3 patients,dizziness in 3 patients,cough and sputum in 2 patients,nausea and vomiting in 2 patients,headache in 2 patients,and chest pain,dry throat,hyperhidrosis,diarrhea,blood in sputum in 1 patient,respectively.The percentage of neutrophils increased in 4 patients,procalcitonin increased in 2 patients,alanine aminotransferase increased in 2 patients,and creatine kinase increased in 2 patients.All the 6 patients had lung consolidation by imaging examination,which was manifested as unclear flaky exudation shadow,partly unclear edge,and visible air bronchial sign.All 6 patients were misdiagnosed as common community-acquired pneumonia.The misdiagnosis las-ted 5-9 d.All the 6 patients were diagnosed with chlamydia psittaci pneumonia by bronchoalveolar lavage fluid metagenomic next-generation sequencing.After receiving targeted anti-infection treatment,their condition improved and they were dis-charged from hospital.No death was reported.Conclusion For patients with acute onset,high fever accompanied by cough and dyspnea,and large and unclear flaky exudation shadow on imaging,who have failed to respond to empirical anti-infective treatment,especially those with a history of contact with poultry or birds,chlamydia psittaci pneumonia should be highly sus-pected,and bronchoalveolar lavage fluid metagomic next-generation sequencing should be performed when necessary to make early diagnosis,reduce misdiagnosis and mistreatment.Targeted treatment should be given as soon as possible,to prevent the progression of the disease to a critical condition.关键词
鹦鹉热衣原体/肺炎/高热/误诊/社区获得性肺炎/支气管镜/肺泡灌洗液/宏基因组二代测序Key words
Chlamydia psittaci/Pneumonia/Hyperthermia/Misdiagnosis/Community-acquired pneumonia/Bron-choscopes/Alveolar lavage fluid/Metagenomic next-generation sequencing分类
医药卫生
