宏基因组二代测序诊断兽类衣原体重症肺炎合并多器官衰竭1例

Chlamydia pecorum pneumonia complicated with multiple organ failure detected by metagenomic next-generation sequencing:a case report

兽类衣原体是一种革兰阴性专性细胞内病原体,属于衣原体科,可广泛感染动物,包括绵羊、山羊、牛和野生动物。人感染兽类衣原体是罕见病,临床症状无特异。本报告中的患者,男性,75岁,因腹痛、恶心、呕吐、腹泻伴发热、呼吸短促,被诊断为重症社区获得性肺炎、呼吸衰竭、休克和急性肾损伤。有羊密切接触史,胸部CT提示炎性渗出,右肺斑片影,左肺实变。通过宏基因组二代测序(mNGS)从患者支气管肺泡灌洗液中检测出兽类衣原体,结合临床表现、病史,确诊为兽类衣原体重症肺炎合并多器官衰竭。经针对性抗感染及综合治疗后,患者病情无明显改善,自动出院。通过报告此病例的诊疗经过,旨在提高临床医生对兽类衣原体感染的认识,早期采取针对性治疗,降低其死亡风险。

Chlamydia pecorum(C.pecorum)is a Granr negative obligate intacllular pathogen belonging to the Chla mydiaceae family.It can infect a wide range of animals.including sheep.goat.cattle,and wild animals.Hu man infection with C pecorum is tare and without specifice clinial symptomns.A 75-year old male patient was diag nosed with severe ommnunity aquirel pneumnoria,espitatory failure.shock,and acute kidney injury due to abr dominal pain.nausea.vomniting.diarthea.fever.and shortness of breath.The patient had a history of close contact with sheep.and chest CT showed inflammatory exudation.patchy shadows in the right lung.and consolidlation in the let lung.C.pecorum was detected from patient's bronchoalveolar lavaee fluid through metagenomic next gene-ration sequencing(mNGS).combined with dlinical manifestat ions and medical history.the patient was confirmed with severe pneumonia caused by C.pecorum and multiple ogan failure.Despite targeted anti infective and compre-hensive treatrnent.the patient's condition didn't imnptove significantly and he was autocnatically discharged This paper feports the diagnosis and treatnent processes of this case.aiming to incteae clinical awareness onC.peco-rum infection.to take targeted treatment at the early stage.and to reduce the risk of mortality.