宏基因组二代测序辅助诊断鹦鹉热一例并文献复习

doi:10.19983/j.issn.2096-8493.2024016

摘要/Abstract

摘要：

目的：探讨鹦鹉热的临床特征、流行病学特点、诊治及预后。方法：回顾性分析山东省千佛山医院呼吸与危重症医学科收治的1例鹦鹉热衣原体肺炎患者,对其诊治过程进行分析。以“Psittacosis”为检索词检索PubMed数据库,以“鹦鹉热”为检索词检索万方数据库、维普数据库及中国知网,对相关文献进行分析。结果：患者,男性,52岁,因“发热、咳嗽20d”入院,既往有高血压病史。患者于院外先后经过莫西沙星和头孢哌酮钠舒巴坦钠抗感染治疗,但病情未见改善。转入我科后,通过肺泡灌洗液宏基因组二代测序(metagenomic next-generation sequencing,mNGS)检出鹦鹉热衣原体,确诊为鹦鹉热衣原体肺炎。经左氧氟沙星联合米诺环素治疗后好转出院。通过回顾文献发现,鹦鹉热是一种人畜共患疾病,可累及全身多系统,其中呼吸系统受累最为常见。此病可在人际间传播。宏基因组高通量测序技术相较于血清学、病原体分离培养、聚合酶链反应(polymerase chain reaction,PCR)等传统检测手段具有优越性。治疗首选四环素类药物,疗程为2~3周。该病的预后较好,整体病亡率约为1%。结论：鹦鹉热为人畜共患疾病,需要早期治疗。该疾病临床特征和检查结果缺乏特异性,误诊率和漏诊率均较高。宏基因组高通量测序技术在诊断该病方面具有优势。治疗首选四环素类药物,预后较好。

关键词: 鹦鹉热, 衣原体, 肺炎, 宏基因组二代测序, 总结性报告(主题)

Abstract:

Objective: To investigate the clinical features, epidemiological features, diagnosis, treatment and prognosis of psittacosis. Methods: A case of Chlamydia psittaci pneumonia admitted to the Pulmonary and Critical Care Medicine of Shandong Provincial Qianfoshan Hospital was retrospectively reviewed. The diagnosis and treatment was analyzed. Using “Psittacosis” as search terms, relevant literature was searched from the PubMed, Wanfang, WIP, CNKI databases and then analyzed. Results: The patient was 52-year-old, male, had a history of hypertension, and admitted to the hospital due to “fever and cough for 20 days”. He had been treated with moxifloxacin and cefoperazone-sulbactam before admission, but the condition did not improve. Psittacosis pneumonia was confirmed by detecting Chlamydia psittaci in the bronchoalveolar lavage fluid using metagenomic next-generation sequencing after that the patient was transferred to our department. The patient improved after treatment with levofloxacin combined with minocycline and was discharged from the hospital. Through literature review, it was found that psittacosis is a zoonotic disease that can affect multiple systems in the body, with the respiratory system being affected most commonly. This disease can be transmitted between humans. Metagenomic high-throughput sequencing technology has more advantages than traditional detection methods such as serology, pathogen isolation and culture, and polymerase chain reaction. Tetracycline drugs are the preferred treatment with a duration of 2-3 weeks. The prognosis of this disease is generally good, with an overall mortality rate of approximately 1%. Conclusion: Psittacosis is a zoonotic disease that requires early treatment. Because of lack of specificity of the clinical characteristics and examination results, the rates of misdiagnosis and missed diagnosis are high. Metagenomic high-throughput sequencing technology has advantages in diagnosing this disease. Tetracycline drugs are the preferred treatment with good prognosis in general.

Key words: Psittacosis, Chlamydophila pneumoniae, Metagenomic next-generation sequencing, Consensus development conferences as topic

中图分类号:

袁永龙, 李慧梅, 马德东. 宏基因组二代测序辅助诊断鹦鹉热一例并文献复习[J]. 结核与肺部疾病杂志, 2024, 5(2): 113-119. doi: 10.19983/j.issn.2096-8493.2024016

Yuan Yonglong, Li Huimei, Ma Dedong. Metagenomic next-generation sequencing assisted in the diagnosis of psittacosis: a case report and literature review[J]. Journal of Tuberculosis and Lung Disease, 2024, 5(2): 113-119. doi: 10.19983/j.issn.2096-8493.2024016

图/表 1

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