Chlamydia pneumoniae replicates in Kupffer cells in mouse model of liver infection

AIM: To develop an animal model of liver infection with Chlamydia pneumoniae (C. pneumoniae) in intraperito-neally infected mice for studying the presence of chlamy-diae in Kupffer cells and hepatocytes.METHODS: A total of 80 BALB/c mice were inoculated intraperitoneally with C. pneumoniae and sacrificed at various time points after infection. Chlamydiae were looked for in liver homogenates as well as in Kupffer cells and hepatocytes separated by liver perfusion with collagenase. C. pneumoniae was detected by both isola-tion in LLC-MK2 cells and fluorescence in situ hybridiza-tion (FISH). The releasing of TNFA-α by C. pneumoniae in vitro stimulated Kupffer cells was studied by enzyme-linked immunosorbent assay.RESULTS: C. pneumoniae isolation from liver homoge-nates reached a plateau on d 7 after infection when 6 of 10 animals were positive, then decreased, and became negative by d 20. C. pneumoniae isolation from sepa-rated Kupffer cells reached a plateau on d 7 when 5 of 10 animals were positive, and became negative by d 20. The detection of C. pneumoniae in separated Kupffer cells by FISH, confirmed the results obtained by culture. Isolated hepatocytes were always negative. Stimula-tion of Kupffer cells by alive C. pneumoniae elicited high TNF-α levels. CONCLUSION: A productive infection by C. pneumo-niae may take place in Kupffer cells and C. pneumoniae induces a local pro-inflammatory activity. C. pneumoniae is therefore, able to act as antigenic stimulus when local-ized in the liver. One could speculate that C. pneumoniaeinfection, involving cells of the innate immunity such as Kupffer cells, could also trigger pathological immune re-actions involving the liver, as observed in human patients with primary biliary cirrhosis.

Relationship between Chlamydia pneumoniae infection and occurrence of bronchial asthma

Objective: To study the relationship between Chlamydia pneumoniae (C. pneumoniae) infection and asthma exacerbation. Methods: A prospective study of C. pneumoniae infection was conducted in 75 patients with asthma and 63 patients with respiratory tract infection, and 100 blood donors served as controls. The presence of infection was convinced by the polymerase chain reaction and direct immunofluorescence assay for C. pneumoniae DNA from throat swab specimens and micro-immunofluorescence testing for C. pneu-moniae-specific IgG, IgM and IgA antibodies. Results: Prevalence of specific IgG in asthma patients (81. 3%) was higher than that of the blood donors (68. 0%, P<0. 05) and was not significantly different from respiratory tract infection patients (68. 0%, P>0. 05). The acute C. pneumoniae infection rate of symptomatic asthma patients (59. 4%) was markedly higher than that of respiratory tract infection patients (34. 9% , P<0. 05). The average titer of C. pneumoniae IgG instead of IgA in asthma patients (48. 38±6. 94) was significantly higher than respiratory tract infection patients (24. 70±8. 77, P<0. 05). Other pathogens were identified in 12 of 21 (57. 1%) asthma patients with C. pneumoniae. The symptoms of 7 asthma patients with C. pneumoniae infection were improved through antibiotic treatment. Conclusion: The findings suggest a possible role of C. pneumoniae infection in asthma.

The Study of Chlamydia Pneumoniae DNA in the Peripheral Blood Mononuclear Cell of Coronary Heart Disease

Objectives To detection of chlamydia pneumoniae (Cpn) DNA in the circulating mononuclear cell fractions of coronary heart disease and to investigate the association between infection with chlamydia pneumoniae and coronary heart disease (CHD) and prospectively whether blood - based nes- ted polymerase chain reaction(nPCR ) is useful in i- dentifying Cpn infection. Methods The peripheral blood mononuclear cell (PBMC) Cpn DNA was exam- ined using nPCR technique and confirmed by electro- phoresis in 150 patients with CHD. Select 55 patients with clinical suspected CHD but angiography result are normal as control group (CG). Then we conducted a prospective , randomized, double - blind, placebo - controlled study of 6 months of azithromycin and place- bo treatment in CHD group. Patients with Cpn DNA positive were then randomized to receive azithromycin or placebo. After treatment blood sample were collect- ed for repeated measurement . Results Chlamydia pneumoniae DNA was detected in 49(32. 7% ) of 150 persons with CHD and in 1 (1. 8% ) of 55 persons with control group,odds ratio 26. 2, 95% confidence interva 13. 52 - 194. 98. The positivity rates of nPCR in CHD groups were higher than those in control group. 16 ca- ses (29. 1%) in latent coronary heart diseases (LCHD)group , 19 cases (39.6%) in unstable angi- na(UAP) group ,and 14 cases (29.9% ) in acute my- ocardial infarction (AMI) group were Cpn positive by nPCR. There were no significant difference among in AMI^UAP and LCHD group. There were significiantdifference in Cpn DNA negative rates after the azithro- mycin and the placebo treatment. Conclusions Chlamydia pneumoniae is present in PBMC of a signifi- cant proportion of persons with CHD. The potential role of chlamydia pneumoniae in coronary atherosclerosis may therefore be more related to acceleration of disease or systemic effects by persistent infection than to sud- den initiation of progressive coronary artery disease by acute infection. The detection of Cpn DNA in PBMC with nPCR may be of great value for identifying Cpn carriers and for monitoring antichlamydial therapy.

Analysis of the effect of Chlamydia pneumoniae on the lipid metabolism of mononuclear macrophages in patients with carotid atherosclerotic plaque

Objective:To explore the effect of Chlamydia pneumoniae on the lipid metabolism of mononuclear macrophages in patients with carotid atherosclerotic plaque.Methods: A total of 90 patients with carotid atherosclerosis who were admitted in our hospital from January, 2012 to December, 2013 were included in the study and served as the observation group, while 72 aged individuals at the same stage for physical examination were served as the control group. The plaque formation in the two groups was observed and compared. The levels of TC, LDL-C, and HDL-C in the two groups were detected and compared. ELISA was used to detect CP IgG. The positive rate of CP IgG in the two groups was compared.Results: The multiple plaque, soft plaque, and mixed plaque in the observation group were significantly greater than those in the control group, but the comparison of hard plaque between the two groups was not statistically significant. The levels of TC and LDL-C in the observation group were significantly higher than those in the control group, while HDL-C level was significantly lower than that in the control group. The positive rate of CP IgG in the observation group was significantly higher than that in the control group.Conclusions: Chlamydia pneumoniae has an important effect on the lipid metabolism of mononuclear macrophages in patients with carotid atherosclerotic plaque.

The Role of Chlamydia pneumoniae in the Atherosclerotic Process of Patients under 50 Years of Age Who Underwent Coronary Artery Bypass Graft Surgery

Background: To evaluate the presence of C. pneumoniae DNA in the tissues and C. pneumoniae DNA antibodies in the blood samples of patients who underwent CABG surgery. Material and Methods: Fifty-one patients aorta. C. pneumoniae DNA was evaluated in the tissues collected from the atrium, left internal thoracic artery and ascending aorta of patients. Results: Although, C. pneumoniae DNA was negative in the atrial and left internal thoracic artery tissues of all patients, it was positive in the tissues obtained from the ascending aortas of twelve patients. C. pneumoniae DNA positivity was significantly higher in patients with increased aortic intimal thickness compared to those without increased aortic thickness. Conclusion: The question whether C. pneumoniae is triggering atherosclerosis or is involved as a super-infection could not be clarified.

Correlation of Chlamydia pneumonias infection with primary biliary cirrhosis

AIM:To evaluate the association between Chlamydia pneumoniae (Cpn) infection and primary biliary cirrhosis (PBC). METHODS: CpnIq/G and IgM were determined by enzyme-linked immunosorbent assay (ELBA) in 41 well-established PBC patients and two race-matched control groups (post-hepatitis cirrhosis, n = 70; healthy controls, n = 57). RESULTS: The mean level and seroprevalence of Cpn IgG in PBC group and post-hepatitis cirrhosis (PHC) group were significantly higher than those in healthy controls (46.8±43.4 RU/mL, 49.5±45.2 RU/mL vs28.3±32.7 RU/mL; 68.3%, 71.4%, 42.1%, respectively; P<0.05). There was a remarkably elevated seroprevalence of Cpn IgM in patients with PBC (22.0%) compared to the PHC and healthy control (HC) groups. For the PBC patients versus the HCs, the odds ratios (ORs) of the presence of Cpn IgG and IgM were 2.7 (95% CI 0.9-6.1) and 5.1 (95% CI 1.4-18.5), respectively. Though there was no correlation in the level of Cpn IgG with total IgG in sera of patients with PBC (r = -0.857, P = 0.344>0.05), Cpn IgM was related with the abnormally high concentrations of total IgM in PBC group. CONCLUSION: The results of this study do not support the hypothesis that infection with Chlamydia pneumoniae may be a triggering agent or even a causative agent in PBC, but suggest that Chlamydia pneumoniae infection probably contributes to the high level of IgM present in most patients with PBC.

Clinical metagenomic sequencing for rapid diagnosis of pneumonia and meningitis caused by Chlamydia psittaci

BACKGROUND Chlamydia psittaci(C.psittaci)is a gram-negative intracellular parasitic pathogenic bacterium that can infect avian and mammalian hosts,including humans.The detection of C.psittaci infections typically relies on traditional antigen-based immunoassays or serological testing that often lack sensitivity and/or specificity.Metagenomic next generation sequencing(mNGS)is an emerging tool for diagnosis.AIM To demonstrate that mNGS represents a valuable tool for rapid,sensitive,and accurate pathogen detection including C.psittaci infections.METHODS Four cases of psittacosis pneumonia and one case of pediatric psittacosis meningitis were diagnosed between December 2019 and May 2020 using mNGS at Changzhou Second People’s Hospital affiliated to Nanjing Medical University.Patients’clinical characteristics,manifestations,and treatment histories were retrospectively evaluated.RESULTS All five patients had a history of exposure to wild(psittacine or other birds)or domesticated birds(chickens).All patients had a high fever(>39℃)and three of them(60%)experienced organ insufficiency during the disease.The laboratory data showed normal to slightly increased leucocyte and neutrophil counts,and elevated procalcitonin levels in all five cases,and very high C-reactive protein levels in psittacosis pneumonia patients.mNGS identified a potential pathogen,C.psittaci,in patients’bronchoalveolar lavage fluid or cerebrospinal fluid.Computed tomography revealed lung air-space consolidation,pleural thickening,and effusion fluid buildup in psittacosis pneumonia cases,and an arachnoid cyst in the right temporal lobe of the pediatric psittacosis meningitis patient.All patients experienced complete recovery following the administration of targeted antichlamydia therapy.CONCLUSION This study not only demonstrated that mNGS represents a valuable tool for rapid,sensitive,and accurate pathogen detection,but also raised public health concerns over C.psittaci infections.

Seropositivity of Chlamydophila pneumoniae immunoglobulin G antibody of HIV/AIDS patients in Abuja,Nigeria

Objective:To detect IgG antibody to Chlamydophila pneumoniae(CP) in sera of HIV/AIDS patients and provide rationale for inclusion of routine screening for anti-CP antibodies and anti-chlamydial agents in the Nigerian National H1V/AIDS Management Plan.Methods:Serum samples from 34 consenting HIV/AIDS patients attended a Government-approved Antiretroviral Treatment Facility in Abuja were screened by enzyme-linked immunosorbent assay for anti-CP IgG antibody using ImmunoComb? Chlamydia Bivalent IgG Test kit(Orgenics,Israel).Results: Anti-CP IgG antibody was detected in 20(58.8%) of 34 patients tested.The detection rale was higher among the males(8/13:61.5%) than the females(12/21:57.1%).Patients of the age group 16-30 years had the highest(7/10:70%) detection of anti-CP IgG antibody.Conclusions:The result of the present study suggests the presence of anti-CP antibodies in sera of the HIV/AIDS patients,and reinforces the need for routine screening for anti-CP antibodies as a necessary intervention to reduce the burden of Chlamydophila pneumoniae(C.pneumoniae) infections and to reduce HIV-positive morbidity in Nigeria.The outcome of this study also provides justification for the possible inclusion of anti-chlamydial agents in the National HIV/AIDS Management Plan to provide prophylaxis against or treat active C.pneumoniae infections.

肺炎衣原体CPn0308的基因克隆及其内源性蛋白定位的研究

目的克隆肺炎衣原体基因CPn0308,表达融合蛋白,并制备抗体对其表达的内源性蛋白进行初步定位。方法根据STD基因库提供的信息设计引物,聚合酶链反应(PCR)克隆目的基因,用BamHI/NotI对克隆的目的基因和pGEX-6P2载体进行酶切,T4连接酶连接后,重组质粒经42℃转化XL1-blue细菌;用PCR进行初步筛选,交叉PCR对提取质粒进一步确定,最后对插入片断进行序列分析;用IPTG诱导阳性克隆的细菌使其表达GST融合蛋白,纯化后免疫小鼠制备抗体,使用IFA对内源性蛋白进行定位分析。结果克隆出肺炎衣原体基因CPn0308,全长为366bp,编码121个氨基酸;并表达了融合蛋白GST-CPn0308,分子量约为39kD;制备了抗体,IFA实验发现该蛋白初步定位于肺炎衣原体包涵体膜蛋白上。结论成功克隆肺炎衣原体基因CPn0308,其内源性蛋白初步定位于肺炎衣原体包涵体膜上。

黄芩苷对CPn感染高胆固醇饮食小鼠血清TNF-α、IL-6、IL-10的调节作用

目的:探讨肺炎衣原体感染高胆固醇饮食小鼠后血清TNF-α、IL-6、IL-10水平的变化及黄芩苷的治疗作用。方法:小鼠随机分为黄芩苷高剂量组、黄芩苷低剂量组、阿奇霉素组、高胆固醇+CPn感染组、正常对照组。喂饲高胆固醇饲料1周后,经一侧鼻腔吸入含CPn的培养液,每周1次,共3次。最后一次接种5天后开始给药至实验结束,第1次接种后第18周处死全部动物。结果:高胆固醇+CPn感染组血清TNF-α、IL-6、IL-10水平不同程度升高,三个治疗组三种炎症因子水平不同程度下降。结论:CPn感染可使高脂饮食C57BL/6J小鼠血清TNF-α、IL-6、IL-10水平升高,早期给予高、低剂量黄芩苷或阿奇霉素治疗可不同程度地调节这三种炎症因子的水平。

肺炎嗜衣原体Cpn0147重组蛋白的免疫学活性研究

目的研究Cpn0147重组蛋白的免疫学活性及其应用于肺炎嗜衣原体(Cpn)感染临床诊断中的价值。方法采用GST琼脂糖凝胶纯化目的蛋白,将Cpn0147重组蛋白免疫新西兰兔,分别应用Westernblot、ELISA法检测其免疫反应性及免疫原性,同时通过检测临床标本以评估其诊断价值。结果成功表达并纯化了相对分子质量约41×103的重组蛋白GST-Cpn0147;Westernblot和ELISA结果显示,该重组蛋白具有良好的免疫反应性,动物实验结果表明该重组蛋白具有较好的免疫原性,ELISA结果显示该重组蛋白免疫新西兰兔血清抗体效价为1:12800。结论 Cpn0147重组蛋白具有较好免疫学活性和特异性,可为Cpn感染的确诊、预防研究奠定基础。

Cpn0308真核表达载体的构建及对小鼠免疫功能的影响

目的:构建Cpn0308重组质粒pcDNA3.1/His A-Cpn0308,将重组质粒腹腔注射小鼠后观察小鼠免疫反应变化,以期为进一步研究Cpn0308免疫保护性奠定基础。方法:构建pcDNA3.1/His A-Cpn0308,并用菌落PCR、双酶切、序列测定等多种技术确定其正确性;将重组质粒转染HeLa细胞,间接免疫荧光法检测细胞内蛋白表达情况;重组质粒免疫BALB/c小鼠,一定时间后Western blot检测血清Cpn0308抗体特异性,间接ELISA法检测小鼠血清中Cpn0308 IgG抗体水平、ELISA试剂盒检测血清中细胞因子。结果:pcDNA3.1/His A-Cpn0308重组质粒构建成功且序列正确;重组质粒转染的HeLa细胞胞浆观察到黄绿色荧光,对照组无荧光;重组质粒组血清抗体A450x±s为0.343±0.024,pcDNA3.1/His A质粒组为0.174±0.018,PBS组为0.156±0.023,WB结果显示重组质粒组小鼠血清稀释800倍后仍有特异性目的条带出现,对照组不出现;重组质粒组小鼠IFN-γ浓度均值为264 ng/L,IL-4浓度均值为22 ng/L,pcDNA3.1/His A质粒组为:IFN-γ120 ng/L,IL-4 10 ng/L,PBS组为:IFN-γ99 ng/L,IL-4 9 ng/L。重组质粒组IgG抗体水平和细胞因子水平明显升高,与对照组相比有统计学差异。结论:pcDNA3.1/His A-Cpn0308真核表达重组质粒构建成功,且能够在真核细胞中表达目的蛋白;重组质粒对小鼠进行免疫后,提高了小鼠血清IgG抗体水平和细胞因子水平,为进一步研究Cpn DNA疫苗以及研究该蛋白的生物学功能提供实验基础。

高脂、蛋氨酸饮食及CPn感染对小鼠动脉粥样硬化的影响

目的:探讨高脂饮食、高同型半胱氨酸血症及肺炎衣原体感染对小鼠血清IL-1β、Hs-CRP、内膜下单核细胞浸润计数、热休克蛋白染色表达的影响。方法:采用高脂及蛋氨酸饲料饲喂C57BL/6J小鼠并予以肺炎衣原体滴鼻感染(每隔周接种1次,共3次,6周时间)的方式造成AS模型。测定血清学及病理染色指标。结果:高脂+CPn感染和/或高同型半胱氨酸血症对小鼠的血清IL-1β、Hs-CRP、内膜下单核细胞浸润计数、热休克蛋白染色表达均有不同程度升高。结论:CPn感染、高同型半胱氨酸血症可增强高脂饮食致动脉粥样硬化的作用。

外周血PCR和ELISA方法早期诊断婴幼儿Cpn感染

目的探讨婴幼儿肺炎衣原体(Cpn)感染的早期诊断。方法呼吸道感染婴幼儿110例,采用荧光定量PCR(FQ-PCR)技术检测外周血单核细胞Cpn DNA,用ELISA法检测血浆肺炎衣原体IgM抗体。结果110例呼吸系统感染患儿中,PCR和ELISA同时阳性18例,PCR单独阳性15例,IgM单独阳性2例,总计35例,阳性率31.8%。FQ-PCR和ELISA法结果间差异有统计学意义(χ2=4.2007,P<0.05)。结论肺炎衣原体是婴幼儿呼吸道感染的重要病原之一,FQ-PCR可快速、敏感、准确地定量检测外周血CPDNA载量,直接了解肺炎衣原体在患儿体内感染和复制情况。

Cpn、CRP和vWF在冠心病患者血中的变化及临床意义

目的:研究冠心病(CHD)患者肺炎衣原体(Cpn)感染、C反应蛋白(CRP)与血管性假性血友病因子(vWF)的相互关系,从而探讨CHD可能的发病机制。方法:对实验组和正常对照组通过微量免疫荧光法测量Cpn特异性抗体,用免疫比浊法测定CRP,用酶联吸附法测定vWF。结果:CHD患者AMI组、UAP组Cpn特异性抗体阳性率高于对照组,差异有显著性意义(P<0.05),CHD患者Cpn特异性抗体阳性组vWF及CRP水平高于Cpn特异性抗体阴性组(P<0.05)差异有显著性,且血浆vWF及CRP水平与Cpn特异性IgG抗体几何平均滴度呈正相关。结论:Cpn感染激发和加重冠状动脉内炎症反应,使体内vWF水平升高,促进患者血液粘稠度增加,动脉血栓发生率升高,Cpn感染在动脉粥样硬化的发生与发展过程中起着重要作用。

神经退行性疾病潜在致病肺炎衣原体蛋白Cpn0147酵母双杂交诱饵载体的构建

目的:构建Cpn0147酵母双杂交诱饵载体,为应用酵母双杂交系统筛选与其相互作用的蛋白奠定基础。方法:应用聚合酶链式反应(polymerase chain reaction,PCR)扩增技术获得Cpn0147基因片段,克隆入pGBKT7载体,鉴定构建是否成功,确定构建成功后将重组载体pGBKT7-Cpn0147转入AH109及Y187酵母中,进行诱饵载体的毒性及自激活活性分析。结果:Cpn0147诱饵载体构建成功,且该诱饵载体无自激活活性,对两种宿主酵母细胞无毒性。结论:诱饵载体pGBKT7-Cpn0147可用于酵母双杂交系统,为进一步筛选与之相互作用蛋白提供了实验基础。

肺炎衣原体与新型冠状病毒共感染及其对机体炎症因子分泌水平的影响

目的明确肺炎衣原体(Cpn)与新型冠状病毒(SARS-CoV-2)共感染的特征及其对SARS-CoV-2诱导机体炎症反应的影响。方法选取2022年12月20日—2023年2月20日郴州市某医院就诊的新型冠状病毒感染(COVID-19)患者,按COVID-19严重程度将重型和危重型作为重症组,轻型和中型作为轻症组,再依据患者年龄(≥18岁为成年,<18岁为未成年)分为成年重症组、成年轻症组、未成年重症组、未成年轻症组。采用倾向性评分对重症组、轻症组患者的年龄、性别、基础疾病进行1∶1匹配。收集患者支气管肺泡灌洗液(BALF)、咽拭子及血清标本,应用酶联免疫吸附测定法(ELISA)检测Cpn IgG/IgM抗体,流式细胞术检测BALF中白细胞介素(IL)-8等12项常见细胞因子水平,并比较各组之间的差异。结果共纳入102例患者,其中重型和危重型(重症)患者61例,轻型和中型(轻症)患者41例;年龄≥18岁的患者71例,年龄<18岁未成年患者31例。成年重症组患者39例,成年轻型组患者32例,经倾向性评分成功匹配30对;未成年重症组患者22例,未成年轻型组患者9例,经倾向性评分成功匹配8对。COVID-19患者中Cpn IgG、IgM阳性率分别为36.27%(37例)、8.82%(9例),其中1例Cpn IgG和IgM同为阳性。成人重症组合并Cpn IgG阳性患者血清标本中干扰素(IFN)-α水平高于IgG阴性患者(P=0.037),两组患者BALF、血清标本中其他细胞因子水平比较差异均无统计学意义(均P>0.05);成人轻症组合并Cpn IgG阳性患者血清标本中IL-8和IL-17水平均高于Cpn IgG阴性患者(均P<0.05)。未成年轻症组合并Cpn IgM阳性患者BALF及血清标本中IL-8水平均高于Cpn IgM阴性患者(均P<0.05)。Logistic回归分析结果显示,Cpn IgG阳性和IgM阳性都不是导致COVID-19发展成重症的危险因素。结论合并Cpn感染不是导致COVID-19患者发展成重症的危险因素,Cpn感染对SARS-CoV-2导致的炎症因子分泌影响有限。

流产衣原体非典型重症肺炎的诊断及临床特点

目的 探讨流产衣原体非典型重症肺炎的诊断及临床特点。方法 收集2021年1月—2022年11月某院收治并诊断为流产衣原体非典型重症肺炎4例患者的临床资料,全面分析该疾病的临床特征、诊治要点及注意事项。结果 4例患者均为男性,年龄63~73岁,急性起病,均表现为高热、咳嗽、咳痰;3例患者有家禽接触史,1例有流产山羊接触史。4例患者从有临床症状到出现急性呼吸衰竭的间隔时长为1~6 d,且入院时氧合指数(PaO_(2)/FiO_(2))均<200 mmHg,随病情发展呈进行性下降,需积极呼吸机支持。2例患者白细胞计数升高,4例中性粒细胞百分比升高,3例血小板计数轻度降低;4例患者中2例患者天冬氨酸转氨酶升高,2例患者丙氨酸转氨酶升高,3例患者肌酸激酶升高,4例患者血清肌酐均升高,2例轻度低钠血症;4例C反应蛋白、降钙素原、白介素-6明显升高。4例患者胸部CT表现以单个或多个肺叶累及为主,渗出实变,后期累及多个肺叶。支气管肺泡灌洗液宏基因组二代测序均检测出流产衣原体DNA序列。结合4例患者的临床表现、接触史、胸部CT、宏基因组二代测序等结果,诊断为流产衣原体非典型重症肺炎,通过及时调整以多西环素为基础的抗感染治疗方案后,患者病情好转出院。结论 流产衣原体也可能导致人类肺炎发生,感染后可导致严重临床后果,当患者有动物接触史时,需警惕此类疾病;宏基因组二代测序可以检出流产衣原体。

鹦鹉热衣原体肺炎的胸部CT影像表现

目的:探讨鹦鹉热衣原体肺炎的胸部CT影像表现。方法:回顾性分析22例鹦鹉热衣原体肺炎患者的临床及胸部CT资料,分析肺内病变的影像学特点及肺外影像表现。结果:22例鹦鹉热衣原体肺炎中,15例肺内病变表现为大叶性肺炎,5例表现为斑片结节,2例表现为支气管肺炎,常见伴随征象包括:小叶间隔增厚(12例)、小叶内网状影(11例)、铺路石征(6例),少数可见晕征(3例)、反晕征(1例)、小叶中心性结节(1例)、支气管壁增厚(2例)、支气管牵引性扩张(1例)。所有病变均未见坏死或空洞。肺内病变分布:累及单肺19例,双肺3例;累及上肺区6例,下肺区13例,上、下肺区同时受累3例;外周分布12例,支气管血管周围分布4例,弥漫分布6例。10例合并胸腔积液,3例伴纵隔淋巴结增大。结论:鹦鹉热衣原体肺炎的影像表现以大叶性肺炎最多见,典型者表现为斑片状实变伴空气支气管征,多合并磨玻璃密度影,常伴小叶间隔增厚、小叶内网状影及铺路石征等间质受累表现,可见胸腔积液、纵隔淋巴结增大。

鹦鹉热衣原体肺炎的CT表现特征

目的探讨鹦鹉热衣原体肺炎患者的CT表现特征。方法回顾性分析笔者医院经宏基因二代测序(macrogene second-generation sequencing,m NGS)技术确诊10例鹦鹉热衣原体肺炎患者的胸部CT图像。结果7例(70%)患者与鸟(禽)类或其粪便有接触史。入院胸部CT均表现为团片状渗出实变影,均位于单肺,其中累及单叶8例(80%)、双叶2例(20%);10例(100%)均伴有支气管充气征,9例(90%)有磨玻璃影,8例(80%)局部小叶间隔或小叶内间隔增厚;1例(10%)病灶呈“扇形”改变,1例(10%)病灶见“反晕症”,9d内复查9例(90%)有进展,表现为病灶融合增大呈更大范围实变或新出现病灶。结论鹦鹉热衣原体肺炎CT表现具有一定特征,结合鸟(禽)类接触史可提示诊断。