鹦鹉热衣原体肺炎并发机化性肺炎一例并文献复习_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

谢玉芳 ^1,2 , 田火欢 ¹ ,  刘丹 ¹

1. ;
2. ;

Corresponding author：

刘丹, Email: Liudan10965@wchscu.cn

Keywords：

鹦鹉热衣原体; 肺炎; 机化性肺炎; 宏基因组测序; 冷冻肺活检

DOI：

10.7507/1671-6205.202310027

Video：

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目的阐述鹦鹉热衣原体肺炎并发机化性肺炎的临床特点、诊治要点及可能机制。方法报道鹦鹉热衣原体肺炎并发机化性肺炎1例。并以“鹦鹉热衣原体”和“机化性肺炎”为检索词，检索中国知网、万方、维普数据库，以“psittacosis”或“Chlamydia psittaci”和“organizing pneumonia”为检索词，检索PubMed 数据库。结果该鹦鹉热衣原体肺炎并发机化性肺炎患者主要表现为咳嗽、咳痰伴持续高热，外院给予喹诺酮治疗后病情仍进展，行肺泡灌洗液宏基因组测序检出鹦鹉热衣原体，并经冷冻肺活检病理示机化性肺炎，给予抗感染联合激素治疗后病情好转，复查胸部CT病灶较前明显吸收，患者最终好转出院。国内外有两篇报道，一篇文献报道1例严重鹦鹉热衣原体肺炎可疑发展为机化性肺炎，另一篇报道从病理学角度证实了鹦鹉热衣原体感染后并发机化性肺炎。结论鹦鹉热衣原体肺炎在临床上易被漏诊，易发展为重症，可并发机化性肺炎，目前机制尚不十分明确，可能考虑与宿主免疫力低下、特殊感染等相关。

Citation： 谢玉芳, 田火欢, 刘丹. 鹦鹉热衣原体肺炎并发机化性肺炎一例并文献复习. Chinese Journal of Respiratory and Critical Care Medicine, 2024, 23(1): 43-46. doi: 10.7507/1671-6205.202310027 Copy

1.	Hogerwerf L, De Gier B, Baan B, et al. Chlamydia psittaci (psittacosis) as a cause of community-acquired pneumonia: a systematic review and meta-analysis. Epidemiol Infect, 2017, 145(15): 3096-3105.
2.	陆晓旻, 朱际平, 陈扬, 等. 基于宏基因组二代测序诊断的鹦鹉热衣原体肺炎的流行病学特征分析. 中国临床研究, 2022, 35(1): 1-5.
3.	Zuzek R, Green M and May S. Severe psittacosis progressing to suspected organizing pneumonia and the role of corticosteroids. Respir Med Case Rep, 2021, 34: 101486.
4.	Gao YD, Zhang XB, Liu J, et al. Chlamydia psittaci pneumonia complicated with organizing pneumonia: a case report and literature review. IDCases, 2022, 30: e01584.
5.	Okubo T, Miyazaki E, Ueo M, et al. A case of psittacosis with wandering infiltrates developing to acute respiratory distress syndrome. Nihon Kokyuki Gakkai Zasshi, 2007, 45(5): 419-423.
6.	郑恒, 吴刚, 徐静, 等. 以听力下降为首发症状的鹦鹉热衣原体肺炎一例并文献复习. 中国呼吸与危重监护杂志, 2022, 21(7): 505-508.
7.	金琳羚, 刘晨阳, 孔辉, 等. 鹦鹉热衣原体肺炎21例临床特征分析. 中国呼吸与危重监护杂志, 2023, 22(8): 559-565.
8.	宋慧慧, 唐昊. 鹦鹉热衣原体致免疫受损患者重症肺炎一例并文献复习. 中国呼吸与危重监护杂志, 2022, 21(1): 12-19.
9.	Fang CQ, Xu LM, Tan JR, et al. Omadacycline for the treatment of severe Chlamydia psittaci pneumonia complicated with multiple organ failure: a case report. Infect Drug Resist, 2022, 15: 5831-5838.
10.	Shi YF, Chen JX, Shi XH, et al. A case of Chlamydia psittaci caused severe pneumonia and meningitis diagnosed by metagenome next-generation sequencing and clinical analysis: a case report and literature review. BMC Infect Dis, 2021, 21(1): 621.
11.	齐亚飞, 黄锦伦, 陈健华, 等. 鹦鹉热衣原体肺炎合并横纹肌溶解一例并文献分析. 中华结核和呼吸杂志, 2021, 44(9): 806-811.
12.	Phin N, Parry-Ford F, Harrison T, et al. Epidemiology and clinical management of Legionnaires' disease. Lancet Infect Dis, 2014, 14(10): 1011-1021.
13.	He LJ, Yang HZ, Liu SG, et al. Physiological analysis of severe Chlamydia psittaci pneumonia and clinical diagnosis after doxycycline-based treatment. Front Physiol, 2023, 14: 1132724.
14.	Yang M, Yang DH, Yang H, et al. Clinical characteristics of Chlamydia psittaci pneumonia infection in Central South China. Infect Dis Ther, 2022, 11(4): 1631-1647.
15.	Krupar R, Kumpers C, Haenel A, et al. Cryptogenic organizing pneumonia versus secondary organizing pneumonia. Pathologe, 2021, 42(1): 55-63.
16.	Beardsley B, Rassl D. Fibrosing organising pneumonia. J Clin Pathol, 2013, 33(10): 875-881.
17.	Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med, 2013, 188(6): 733-748.
18.	何彦侠, 李秀业, 熊鑫, 等. 感染后机化性肺炎临床诊断及治疗分析. 疑难病杂志, 2019, 18(2): 151-154.
19.	Knittler MR, Berndt A, Bocker S, et al. Chlamydia psittaci: new insights into genomic diversity, clinical pathology, host-pathogen interaction and anti-bacterial immunity. Int J Med Microbiol, 2014, 304(7): 877-893.
20.	Chonabayashi N, Nakatani T, Otani M, et al. Successful treatment of a patient with fulminant psittacosis. Nihon Kyobu Shikkan Gakkai Zasshi, 1989, 27(3): 357-366.
21.	Hirata M, Noto M, Oda K, et al. A case of psittacosis presenting as adult respiratory distress syndrome and successfully treated with steroid pulse therapy. Kokyu To Junkan, 1988, 36(8): 893-897.

1. Hogerwerf L, De Gier B, Baan B, et al. Chlamydia psittaci (psittacosis) as a cause of community-acquired pneumonia: a systematic review and meta-analysis. Epidemiol Infect, 2017, 145(15): 3096-3105.
2. 陆晓旻, 朱际平, 陈扬, 等. 基于宏基因组二代测序诊断的鹦鹉热衣原体肺炎的流行病学特征分析. 中国临床研究, 2022, 35(1): 1-5.
3. Zuzek R, Green M and May S. Severe psittacosis progressing to suspected organizing pneumonia and the role of corticosteroids. Respir Med Case Rep, 2021, 34: 101486.
4. Gao YD, Zhang XB, Liu J, et al. Chlamydia psittaci pneumonia complicated with organizing pneumonia: a case report and literature review. IDCases, 2022, 30: e01584.
5. Okubo T, Miyazaki E, Ueo M, et al. A case of psittacosis with wandering infiltrates developing to acute respiratory distress syndrome. Nihon Kokyuki Gakkai Zasshi, 2007, 45(5): 419-423.
6. 郑恒, 吴刚, 徐静, 等. 以听力下降为首发症状的鹦鹉热衣原体肺炎一例并文献复习. 中国呼吸与危重监护杂志, 2022, 21(7): 505-508.
7. 金琳羚, 刘晨阳, 孔辉, 等. 鹦鹉热衣原体肺炎21例临床特征分析. 中国呼吸与危重监护杂志, 2023, 22(8): 559-565.
8. 宋慧慧, 唐昊. 鹦鹉热衣原体致免疫受损患者重症肺炎一例并文献复习. 中国呼吸与危重监护杂志, 2022, 21(1): 12-19.
9. Fang CQ, Xu LM, Tan JR, et al. Omadacycline for the treatment of severe Chlamydia psittaci pneumonia complicated with multiple organ failure: a case report. Infect Drug Resist, 2022, 15: 5831-5838.
10. Shi YF, Chen JX, Shi XH, et al. A case of Chlamydia psittaci caused severe pneumonia and meningitis diagnosed by metagenome next-generation sequencing and clinical analysis: a case report and literature review. BMC Infect Dis, 2021, 21(1): 621.
11. 齐亚飞, 黄锦伦, 陈健华, 等. 鹦鹉热衣原体肺炎合并横纹肌溶解一例并文献分析. 中华结核和呼吸杂志, 2021, 44(9): 806-811.
12. Phin N, Parry-Ford F, Harrison T, et al. Epidemiology and clinical management of Legionnaires' disease. Lancet Infect Dis, 2014, 14(10): 1011-1021.
13. He LJ, Yang HZ, Liu SG, et al. Physiological analysis of severe Chlamydia psittaci pneumonia and clinical diagnosis after doxycycline-based treatment. Front Physiol, 2023, 14: 1132724.
14. Yang M, Yang DH, Yang H, et al. Clinical characteristics of Chlamydia psittaci pneumonia infection in Central South China. Infect Dis Ther, 2022, 11(4): 1631-1647.
15. Krupar R, Kumpers C, Haenel A, et al. Cryptogenic organizing pneumonia versus secondary organizing pneumonia. Pathologe, 2021, 42(1): 55-63.
16. Beardsley B, Rassl D. Fibrosing organising pneumonia. J Clin Pathol, 2013, 33(10): 875-881.
17. Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med, 2013, 188(6): 733-748.
18. 何彦侠, 李秀业, 熊鑫, 等. 感染后机化性肺炎临床诊断及治疗分析. 疑难病杂志, 2019, 18(2): 151-154.
19. Knittler MR, Berndt A, Bocker S, et al. Chlamydia psittaci: new insights into genomic diversity, clinical pathology, host-pathogen interaction and anti-bacterial immunity. Int J Med Microbiol, 2014, 304(7): 877-893.
20. Chonabayashi N, Nakatani T, Otani M, et al. Successful treatment of a patient with fulminant psittacosis. Nihon Kyobu Shikkan Gakkai Zasshi, 1989, 27(3): 357-366.
21. Hirata M, Noto M, Oda K, et al. A case of psittacosis presenting as adult respiratory distress syndrome and successfully treated with steroid pulse therapy. Kokyu To Junkan, 1988, 36(8): 893-897.

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