以发热并发气促、咯血为表现的鹦鹉热衣原体肺炎一例报告并文献复习_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

谢廷逸 ¹ , 黄智兰 ¹ ,  谢纬 ² , 吕萌 ²

1. ;
2. ;

Corresponding author：

谢纬, Email: xiew0703@163.com

Keywords：

鹦鹉热; 咯血; 支气管镜冷冻治疗

DOI：

10.7507/1671-6205.202312026

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的总结鹦鹉热衣原体感染的临床特征，探讨鹦鹉热衣原体感染出现咯血的发生机制及治疗手段，提高临床对本病的认识。方法报道国内首例经支气管镜冷冻技术治疗鹦鹉热衣原体感染出现咯血患者的诊疗经过，并回顾国内外数据库建库至今，筛选及总结分析鹦鹉热衣原体感染导致咯血的文献报道。结果患者为38岁女性，以发热并发气促、咯血为主要表现，经肺泡灌洗液宏基因组二代测序（metagenomics next-generation sequencing，mNGS）检测诊断为鹦鹉热衣原体肺炎。通过药物对症处理以及经支气管镜冷冻治疗后病情好转。结合相关文献和该病例，共10例患者因鹦鹉热衣原体感染出现咯血的表现。结论鹦鹉热衣原体感染早期临床表现无特异性，临床问诊需追溯鸟类及家禽接触史，mNGS能较为精准鉴定病原体。现鹦鹉热衣原体感染治疗首选四环素类药物，大环内酯类及喹诺酮类抗生素也有效。本例通过支气管镜冷冻技术治疗后病情好转，为临床治疗鹦鹉热衣原体感染出现咯血提供经验参考，但关于发生机制及其他诊疗思路仍值得深入研究。

Citation： 谢廷逸, 黄智兰, 谢纬, 吕萌. 以发热并发气促、咯血为表现的鹦鹉热衣原体肺炎一例报告并文献复习. Chinese Journal of Respiratory and Critical Care Medicine, 2024, 23(5): 346-351. doi: 10.7507/1671-6205.202312026 Copy

1.	Sun L, Li P, Pang B, et al. Gestational psittacosis with secondary hemophagocytic syndrome: a case report and literature review. Front Med (Lausanne), 2021, 8: 755669.
2.	Zhu Z, Wang X, Zhao J, et al. Clinical characteristics of six patients with chlamydia psittaci infection diagnosed by metagenomic next-generation sequencing: a case series. Infect Drug Resist, 2023, 16: 869-878.
3.	Dai J, Lian X, Mo J, et al. Case report: a clinical case study of six patients with Chlamydia psittaci pneumonia. Front Cell Infect Microbiol, 2023, 13: 1084882.
4.	Chau S, Tso EY, Leung WS, et al. Three cases of atypical pneumonia caused by Chlamydophila psittaci. Hong Kong Med J, 2015, 21(3): 272-275.
5.	Wu Y, Xu X, Liu Y, et al. Case Report: clinical analysis of a cluster outbreak of chlamydia psittaci pneumonia. Front Cell Infect Microbiol, 2023, 13: 1214297.
6.	张长强, 郭松喜, 刘茜, 等. 北京市密云区11例鹦鹉热衣原体肺炎临床及流行病特征分析. 中外医学研究, 2022, 20: 25-29.
7.	李丽, 倪安平, 于维琴. 鹦鹉热衣原体肺炎一例. 中华结核和呼吸杂志, 1999, 22(11): 662-662.
8.	Knittler MR, Sachse K. Chlamydia psittaci: update on an underestimated zoonotic agent. Pathog Dis, 2015, 73(1): 1-15.
9.	Feng Y, Feng YM, Zhang ZH, et al. Prevalence and genotype of Chlamydia psittaci in faecal samples of birds from zoos and pet markets in Kunming, Yunnan, China. J Zhejiang Univ Sci B, 2016, 17(4): 311-316.
10.	Pang Y, Cong F, Zhang X, et al. A recombinase polymerase amplification-based assay for rapid detection of Chlamydia psittaci. Poult Sci, 2021, 100(2): 585-591.
11.	Hogerwerf L, Roof I, de Jong MJK, et al. Animal sources for zoonotic transmission of psittacosis: a systematic review. BMC Infect Dis, 2020, 20(1): 192.
12.	Huang W, Wang F, Cai Q, et al. Epidemiological and clinical characteristics of psittacosis among cases with complicated or atypical pulmonary infection using metagenomic next-generation sequencing: a multi-center observational study in China. Ann Clin Microbiol Antimicrob, 2023, 22(1): 80.
13.	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.
14.	Zhang Z, Zhou H, Cao H, et al. Human-to-human transmission of Chlamydia psittaci in China, 2020: an epidemiological and aetiological investigation. Lancet Microbe, 2022, 3(7): e512-e520.
15.	Yin Q, Li Y, Pan H, et al. Atypical pneumonia caused by Chlamydia psittaci during the COVID-19 pandemic. Int J Infect Dis, 2022, 122: 622-627.
16.	Balsamo G, Maxted AM, Midla JW, et al. Compendium of measures to control Chlamydia psittaci infection among humans (psittacosis) and pet birds (Avian Chlamydiosis), 2017. J Avian Med Surg, 2017, 31(3): 262-282.
17.	Ni Y, Zhong H, Gu Y, et al. Clinical features, treatment, and outcome of psittacosis pneumonia: a multicenter study. Open Forum Infect Dis, 2023, 10(2): ofac518.
18.	Yang F, Li J, Qi B, et al. Clinical symptoms and outcomes of severe pneumonia caused by Chlamydia psittaci in Southwest China. Front Cell Infect Microbiol, 2021, 11: 727594.
19.	郭锋, 陈素婷, 董利民, 等. 鹦鹉热衣原体肺炎临床特点及诊治分析. 中国感染控制杂志, 2022, 21: 675-680.
20.	朱巧珍, 陈柯颖, 陈济明, 等. 五例宏基因组高通量测序诊断鹦鹉热衣原体肺炎的诊治及临床特点分析. 中国呼吸与危重监护杂志, 2022, 21(1): 7-11.
21.	Kong CY, Zhu J, Lu JJ, et al. Clinical characteristics of Chlamydia psittaci pneumonia. Chin Med J (Engl), 2021, 134(3): 353-355.
22.	Liu J, Gao Y. Tigecycline in the treatment of severe pneumonia caused by Chlamydia psittaci: a case report and literature review. Front Med (Lausanne), 2022, 9: 1040441.
23.	李田田, 朱淼, 左华芹, 等. 重症鹦鹉热衣原体肺炎的早期影像学特征分析. 临床放射学杂志, 2023, 42: 1238-1242.
24.	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.
25.	Smith KA, Bradley KK, Stobierski MG, et al. Compendium of measures to control Chlamydophila psittaci (formerly Chlamydia psittaci) infection among humans (psittacosis) and pet birds, 2005. J Am Vet Med Assoc, 2005, 226(4): 532-539.
26.	Cui Z, Meng L. Psittacosis pneumonia: diagnosis, treatment and interhuman transmission. Int J Gen Med, 2023, 16: 1-6.
27.	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: 1-5.
28.	Shi Y, Chen J, Shi X, 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.
29.	Stewardson AJ, Grayson ML. Psittacosis. Infect Dis Clin North Am, 2010, 24(1): 7-25.
30.	方昌全, 徐丽敏, 卢健聪, 等. 鹦鹉热衣原体肺炎16例临床特征分析. 中华危重病急救医学, 2021, 33: 1366-1369.
31.	Yung AP, Grayson ML. Psittacosis--a review of 135 cases. Med J Aust, 1988, 148(5): 228-233.
32.	Chen Q, Li Y, Yan X, et al. Chlamydia psittaci plasmid-encoded CPSIT_P7 elicits inflammatory response in human monocytes via TLR4/Mal/MyD88/NF-κB signaling pathway. Front Microbiol, 2020, 11: 578009.
33.	Zhang Z, Wang P, Ma C, et al. Host inflammatory response is the major factor in the progression of Chlamydia psittaci pneumonia. Front Immunol, 2022, 13: 929213.
34.	Wu H, Wang C, Jiang C, et al. Localization and characterization of two putative TMH family proteins in Chlamydia psittaci. Microbiol Res, 2016, 183: 19-25.
35.	Su S, Su X, Zhou L, et al. Severe Chlamydia psittaci pneumonia: clinical characteristics and risk factors. Ann Palliat Med, 2021, 10(7): 8051-8060.
36.	田雪婧, 李南, 朱毅, 等. 炎症在肺血栓栓塞症发生及发展中的作用. 国际呼吸杂志, 2022, 42: 222-226.
37.	北京医师协会呼吸内科专科医师分会咯血诊治专家共识编写组. 咯血诊治专家共识. 中国呼吸与危重监护杂志, 2020, 19(1): 1-11.
38.	徐平, 何亚荣, 曹钰. 急性呼吸窘迫综合征肺毛细血管内皮细胞损伤的生物标志物研究进展. 中华急诊医学杂志, 2022, 31: 564-567.
39.	徐欢, 朱晓维, 朱星星. 鹦鹉热肺炎11例临床特征分析. 浙江医学, 2021, 43: 1332-1334.
40.	戴晓琴, 马纯雪, 蔡月, 等. 头孢哌酮钠舒巴坦钠致凝血功能异常的危险因素分析及护理. 护理学报, 2013, 20: 59-61.
41.	卢晔, 崔会芳, 陈旭君, 等. 冷冻技术在呼吸介入治疗中的应用进展及其并发症防治浅析. 山东大学学报(医学版), 2017, 55: 19-22.
42.	陈庆, 邹俊, 陈丽娟, 等. 经支气管镜冷冻取血栓治疗安全性及疗效分析. 国际呼吸杂志, 2015, 35: 131-135.
43.	Gatt D, Golan Tripto I, Tsaregorodtsev S, et al. Blood clot removal by flexible bronchoscopic cryotherapy in a young child. Pediatr Int, 2023, 65(1): e15420.
44.	Schumann C, Hetzel J, Babiak AJ, et al. Cryoprobe biopsy increases the diagnostic yield in endobronchial tumor lesions. J Thorac Cardiovasc Surg, 2010, 140(2): 417-421.
45.	Hosna A, Haseeb Ul Rasool M, Noff NC, et al. Cryotherapy for the treatment of tracheal stenosis: a systematic review. Cureus, 2023, 15(6): e41012.

1. Sun L, Li P, Pang B, et al. Gestational psittacosis with secondary hemophagocytic syndrome: a case report and literature review. Front Med (Lausanne), 2021, 8: 755669.
2. Zhu Z, Wang X, Zhao J, et al. Clinical characteristics of six patients with chlamydia psittaci infection diagnosed by metagenomic next-generation sequencing: a case series. Infect Drug Resist, 2023, 16: 869-878.
3. Dai J, Lian X, Mo J, et al. Case report: a clinical case study of six patients with Chlamydia psittaci pneumonia. Front Cell Infect Microbiol, 2023, 13: 1084882.
4. Chau S, Tso EY, Leung WS, et al. Three cases of atypical pneumonia caused by Chlamydophila psittaci. Hong Kong Med J, 2015, 21(3): 272-275.
5. Wu Y, Xu X, Liu Y, et al. Case Report: clinical analysis of a cluster outbreak of chlamydia psittaci pneumonia. Front Cell Infect Microbiol, 2023, 13: 1214297.
6. 张长强, 郭松喜, 刘茜, 等. 北京市密云区11例鹦鹉热衣原体肺炎临床及流行病特征分析. 中外医学研究, 2022, 20: 25-29.
7. 李丽, 倪安平, 于维琴. 鹦鹉热衣原体肺炎一例. 中华结核和呼吸杂志, 1999, 22(11): 662-662.
8. Knittler MR, Sachse K. Chlamydia psittaci: update on an underestimated zoonotic agent. Pathog Dis, 2015, 73(1): 1-15.
9. Feng Y, Feng YM, Zhang ZH, et al. Prevalence and genotype of Chlamydia psittaci in faecal samples of birds from zoos and pet markets in Kunming, Yunnan, China. J Zhejiang Univ Sci B, 2016, 17(4): 311-316.
10. Pang Y, Cong F, Zhang X, et al. A recombinase polymerase amplification-based assay for rapid detection of Chlamydia psittaci. Poult Sci, 2021, 100(2): 585-591.
11. Hogerwerf L, Roof I, de Jong MJK, et al. Animal sources for zoonotic transmission of psittacosis: a systematic review. BMC Infect Dis, 2020, 20(1): 192.
12. Huang W, Wang F, Cai Q, et al. Epidemiological and clinical characteristics of psittacosis among cases with complicated or atypical pulmonary infection using metagenomic next-generation sequencing: a multi-center observational study in China. Ann Clin Microbiol Antimicrob, 2023, 22(1): 80.
13. 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.
14. Zhang Z, Zhou H, Cao H, et al. Human-to-human transmission of Chlamydia psittaci in China, 2020: an epidemiological and aetiological investigation. Lancet Microbe, 2022, 3(7): e512-e520.
15. Yin Q, Li Y, Pan H, et al. Atypical pneumonia caused by Chlamydia psittaci during the COVID-19 pandemic. Int J Infect Dis, 2022, 122: 622-627.
16. Balsamo G, Maxted AM, Midla JW, et al. Compendium of measures to control Chlamydia psittaci infection among humans (psittacosis) and pet birds (Avian Chlamydiosis), 2017. J Avian Med Surg, 2017, 31(3): 262-282.
17. Ni Y, Zhong H, Gu Y, et al. Clinical features, treatment, and outcome of psittacosis pneumonia: a multicenter study. Open Forum Infect Dis, 2023, 10(2): ofac518.
18. Yang F, Li J, Qi B, et al. Clinical symptoms and outcomes of severe pneumonia caused by Chlamydia psittaci in Southwest China. Front Cell Infect Microbiol, 2021, 11: 727594.
19. 郭锋, 陈素婷, 董利民, 等. 鹦鹉热衣原体肺炎临床特点及诊治分析. 中国感染控制杂志, 2022, 21: 675-680.
20. 朱巧珍, 陈柯颖, 陈济明, 等. 五例宏基因组高通量测序诊断鹦鹉热衣原体肺炎的诊治及临床特点分析. 中国呼吸与危重监护杂志, 2022, 21(1): 7-11.
21. Kong CY, Zhu J, Lu JJ, et al. Clinical characteristics of Chlamydia psittaci pneumonia. Chin Med J (Engl), 2021, 134(3): 353-355.
22. Liu J, Gao Y. Tigecycline in the treatment of severe pneumonia caused by Chlamydia psittaci: a case report and literature review. Front Med (Lausanne), 2022, 9: 1040441.
23. 李田田, 朱淼, 左华芹, 等. 重症鹦鹉热衣原体肺炎的早期影像学特征分析. 临床放射学杂志, 2023, 42: 1238-1242.
24. 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.
25. Smith KA, Bradley KK, Stobierski MG, et al. Compendium of measures to control Chlamydophila psittaci (formerly Chlamydia psittaci) infection among humans (psittacosis) and pet birds, 2005. J Am Vet Med Assoc, 2005, 226(4): 532-539.
26. Cui Z, Meng L. Psittacosis pneumonia: diagnosis, treatment and interhuman transmission. Int J Gen Med, 2023, 16: 1-6.
27. 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: 1-5.
28. Shi Y, Chen J, Shi X, 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.
29. Stewardson AJ, Grayson ML. Psittacosis. Infect Dis Clin North Am, 2010, 24(1): 7-25.
30. 方昌全, 徐丽敏, 卢健聪, 等. 鹦鹉热衣原体肺炎16例临床特征分析. 中华危重病急救医学, 2021, 33: 1366-1369.
31. Yung AP, Grayson ML. Psittacosis--a review of 135 cases. Med J Aust, 1988, 148(5): 228-233.
32. Chen Q, Li Y, Yan X, et al. Chlamydia psittaci plasmid-encoded CPSIT_P7 elicits inflammatory response in human monocytes via TLR4/Mal/MyD88/NF-κB signaling pathway. Front Microbiol, 2020, 11: 578009.
33. Zhang Z, Wang P, Ma C, et al. Host inflammatory response is the major factor in the progression of Chlamydia psittaci pneumonia. Front Immunol, 2022, 13: 929213.
34. Wu H, Wang C, Jiang C, et al. Localization and characterization of two putative TMH family proteins in Chlamydia psittaci. Microbiol Res, 2016, 183: 19-25.
35. Su S, Su X, Zhou L, et al. Severe Chlamydia psittaci pneumonia: clinical characteristics and risk factors. Ann Palliat Med, 2021, 10(7): 8051-8060.
36. 田雪婧, 李南, 朱毅, 等. 炎症在肺血栓栓塞症发生及发展中的作用. 国际呼吸杂志, 2022, 42: 222-226.
37. 北京医师协会呼吸内科专科医师分会咯血诊治专家共识编写组. 咯血诊治专家共识. 中国呼吸与危重监护杂志, 2020, 19(1): 1-11.
38. 徐平, 何亚荣, 曹钰. 急性呼吸窘迫综合征肺毛细血管内皮细胞损伤的生物标志物研究进展. 中华急诊医学杂志, 2022, 31: 564-567.
39. 徐欢, 朱晓维, 朱星星. 鹦鹉热肺炎11例临床特征分析. 浙江医学, 2021, 43: 1332-1334.
40. 戴晓琴, 马纯雪, 蔡月, 等. 头孢哌酮钠舒巴坦钠致凝血功能异常的危险因素分析及护理. 护理学报, 2013, 20: 59-61.
41. 卢晔, 崔会芳, 陈旭君, 等. 冷冻技术在呼吸介入治疗中的应用进展及其并发症防治浅析. 山东大学学报(医学版), 2017, 55: 19-22.
42. 陈庆, 邹俊, 陈丽娟, 等. 经支气管镜冷冻取血栓治疗安全性及疗效分析. 国际呼吸杂志, 2015, 35: 131-135.
43. Gatt D, Golan Tripto I, Tsaregorodtsev S, et al. Blood clot removal by flexible bronchoscopic cryotherapy in a young child. Pediatr Int, 2023, 65(1): e15420.
44. Schumann C, Hetzel J, Babiak AJ, et al. Cryoprobe biopsy increases the diagnostic yield in endobronchial tumor lesions. J Thorac Cardiovasc Surg, 2010, 140(2): 417-421.
45. Hosna A, Haseeb Ul Rasool M, Noff NC, et al. Cryotherapy for the treatment of tracheal stenosis: a systematic review. Cureus, 2023, 15(6): e41012.

Previous Article
Gas chromatography-mass spectrometry study on composition of volatile organic compounds in exhaled breath of radiation-damaged rats
Next Article
隐源性机化性肺炎的临床特点分析

Chinese Journal of Respiratory and Critical Care Medicine

以发热并发气促、咯血为表现的鹦鹉热衣原体肺炎一例报告并文献复习

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content