社区获得性鹦鹉热衣原体肺炎1例并文献复习

One case of community-acquired Chlamydia psittaci pneumonia and literature review

71岁男性患者,因发热伴咳嗽、乏力2周于2021年4月21日就诊宁夏吴忠市人民医院呼吸与危重症医学Ⅱ科。胸部CT左肺上叶近胸膜处片状实变影。经抗感染治疗后左肺实变影范围扩大。遂行支气管镜肺泡灌洗送宏基因二代测序,结果提示见鹦鹉热衣原体。结合患者病史及临床症状诊断为社区获得性鹦鹉热衣原体肺炎,给予左氧氟沙星治疗。经治疗后患者发热症状缓解,呼吸道症状好转,复查胸部CT左肺上叶实变明显吸收,治疗疗程13 d。本文将此病例的诊疗过程分享,为难以明确病原的社区获得性肺炎提供临床经验。

A 71-year-old male patient was treated at Second Department of Respiratory and Critical Care Medicine,Wuzhong People's Hospital because of fever,cough,and malaise for 13 days weeks.The chest CT showed that the upper lobe of the left lung had a consolidation shadow near the pleura.The consolidation shadow was enlarged after anti-infection treatment.Bronchoscopic alveolar lavage was performed for metagenomic next-generation sequencing,and the results suggested Chlamydia psittaci.The patient's medical history and clinical symptoms led to the diagnosis of community-acquired Chlamydia psittaci pneumonia.The patient was treated with levofloxacin.His temperature returned to normal;his respiratory symptoms were improved;the consolidation shadow in the upper lobe of the left lung was significantly resolved on chest CT.The treatment course was 13 days.The treatment course of this case was shared to provide clinical experience for community-acquired pneumonia difficult to define etiology.