Journal Article

Diagnosis and treatment experience of Chlamydia psittaci pneumonia: A multicenter retrospective study in China

Shi, Yeshuang, Han, Wenya, Xie, Mei, Zang, Xuelei, Zang, Xuefeng, Ma, Wenjuan, Rao, Youpeng, Wu, Jing, He, Jiawei, Pan, Lei, Ding, Maoqian, Xue, Xinying, Ma, Xidong, Deng, Hui

2024

Overview

Background In recent years, clinical cases of Chlamydia psittaci pneumonia have gradually increased. Chlamydia psittaci pneumonia can quickly progress to severe pneumonia, leading to respiratory failure. Chlamydia psittaci cannot be detected by commonly used detection methods, leading to difficulties in clinical diagnosis and treatment, which may eventually develop into severe Chlamydia psittaci pneumonia. Therefore, we should improve our diagnostic and treatment capabilities for this disease. Methods This article retrospectively studied 61 cases of pneumonia from 12 different provinces in China, and classified them into severe pneumonia and non-severe pneumonia. Divided into two groups, with 23 cases of severe pneumonia and 38 cases of non-severe pneumonia. We compared the two groups in terms of imaging, laboratory testing, treatment, prognosis, etc., hoping to provide better explanations and help clinical physicians better diagnose the disease. Results There is no difference in age, gender, contact history, smoking history, or basic disease between severe and non-severe Chlamydia psittaci pneumonia. The most prominent symptom is fever, with a median body temperature of 39.7 ℃, and other symptoms similar to common respiratory infections. White blood cells and neutrophils may not show significant elevation, but C-reactive protein (CRP) and procalcitonin (PCT) will both show significant elevation, often accompanied by a decrease in arterial oxygen pressure. Some patients may experience liver and kidney dysfunction, but there is no statistically significant difference between the two groups. Doxycycline remains the preferred drug for severe Chlamydia psittaci pneumonia. The imaging mainly shows consolidation and bronchial inflation sign, and may also present with pleural effusion. Conclusions The imaging of Chlamydia psittaci pneumonia usually shows consolidation with bronchial inflation sign, which can also be manifested as ground glass changes or solid masses. Atypical images are prone to misdiagnosis in the early stages. There are some differences in laboratory examination and imaging between severe pneumonia and non-severe pneumonia, which can help identify severe patients in the early stage. Metagenomic next-generation sequencing (mNGS) played an important role in the diagnosis of all cases in this article. Timely treatment has a good prognosis for the disease, and imaging lesions can be completely absorbed.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Anti-Bacterial Agents - therapeutic use / Antibiotics / Bacterial pneumonia / Blood / Blood pressure / Body temperature / C-reactive protein / C-Reactive Protein - analysis / Cardiovascular disease / Care and treatment / China - epidemiology / Chlamydia / Chlamydia psittaci / Chlamydial Pneumonia - diagnosis / Chlamydial Pneumonia - drug therapy / Chlamydial Pneumonia - microbiology / Chlamydophila psittaci - isolation & purification / Consolidation / Control / Creatinine / Diagnosis / Diagnostic errors / Disease transmission / Dosage and administration / Doxycycline / Female / Fever / Genetic aspects / Health services / Hospitalization / Humans / Identification and classification / Imipenem-cilastatin sodium / Infections / Infectious Diseases / Internal Medicine / Intubation / Kidney diseases / Laboratory tests / Lavage / Leukocytes / Leukocytes (neutrophilic) / Liver diseases / Male / Medical imaging / Medical Microbiology / Medicine / Medicine & Public Health / Metagenomics / Middle Aged / Mortality / Next-generation sequencing / Parasitology / Pathogens / Patients / Pleural effusion / Pneumonia / Prevention / Procalcitonin / Prognosis / Psittacosis - diagnosis / Psittacosis - drug therapy / Psittacosis - microbiology / Respiratory tract infection / Retrospective Studies / Retrospective study / Risk factors / Severe Chlamydia psittaci pneumonia / Sexually transmitted diseases / Statistical analysis / STD / Treatment / Tropical Medicine