Clinical features, diagnosis and treatment of 15 severe Chlamydia psittaci pneumonia cases
10.3760/cma.j.cn311365-20250406-00101
- VernacularTitle:重症鹦鹉热衣原体肺炎15例的临床特征及其诊治
- Author:
Weiyun ZHANG
1
;
Jing CHEN
;
Yan ZHU
Author Information
1. 江南大学附属中心医院(无锡市第二人民医院)呼吸与危重症医学科，无锡 214002
- Publication Type:Journal Article
- Keywords:
Severe pneumonia;
Chlamydia psittaci;
Metagenomic next-generation sequencing;
Glucocorticoids;
Imaging
- From:
Chinese Journal of Infectious Diseases
2025;43(10):615-622
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical features and treatment regimens of patients with severe Chlamydia psittaci pneumonia, so that to improve the understanding and management of severe Chlamydia psittaci pneumonia. Methods:A retrospective analysis was conducted on 15 patients with severe Chlamydia psittaci pneumonia in the Jiangnan University Affiliated Central Hospital and Affiliated Hospital of Jiangnan University from January 2021 to December 2024. The clinical data on demographics, epidemiological history, clinical symptoms, laboratory results, imaging findings, treatment regimens, and prognosis were retrospectively collected and analyzed. Statistical analysis was performed using Fisher′s exact test. Results:Among the 15 patients, 13 were male and two were female, with ages ranging from 44 to 85 years and six over 65 years old. Six patients reported a history of poultry contact. The main complication was respiratory failure(14/15), followed by shock (3/15), rhabdomyolysis (2/15), encephalitis (1/15) and lower extremity deep vein thrombosis (1/15). The main clinical manifestations included fever (15/15), cough (11/15), dyspnea (8/15) and consciousness disturbance (5/15). Laboratory tests showed normal (7/15) or mild elevated (6/15) white blood cell counts, elevated neutrophil counts (9/15), decreased lymphocyte counts (15/15), elevated C-reactive protein (15/15), procalcitonin (11/15), liver enzymes (15/15) and D-dimer (15/15), normal creatinine levels (12/15), elevated creatine kinase (10/15), and decreased oxygenation reserve index (15/15). Chest computed tomography (CT) demonstrated large-scale consolidation (9/15) and patchy streaky opacities (9/15), frequently involving bilateral lungs (10/15). The pleural effusion was noted in 14 cases. Antibiotic regimens included tetracycline combined with fluoroquinolone (eight patients), fluoroquinolone alone (five patients), macrolide combined with fluoroquinolone (one patient), and third-generation tetracycline alone (one patient). Glucocorticoids were administered to seven patients. All 15 cases improved and were discharged from hospital. One-month follow-up showed no statistically significant difference in the incidence of residual streaks between glucocorticoid-treated and non-glucocorticoid-treated patients (1/5 vs 2/4, Fisher′s exact test, P>0.05). Conclusions:The main clinical manifestations of severe Chlamydia psittaci pneumonia are fever, cough, dyspnea, and consciousness disturbance, often complicated with respiratory failure and shock. Chest imaging commonly shows bilateral large-scale consolidation and patchy streaks with pleural effusion. Laboratory results suggest normal or mildly elevated white blood cell counts, decreased lymphocyte counts, elevated inflammatory markers, liver enzymes and thrombus markers. A tetracycline-base regimen is preferred for severe patients. The prognosis is generally favorable under early diagnosis and targeted antimicrobial treatment.
