Clinical analysis of 26 cases of Chlamydia psittaci pneumonia confirmed using metagenomic next-generation sequencing / 中华传染病杂志

ABSTRACT

Objective:To explore the clinical characteristics and treatment strategies for Chlamydia psittaci pneumonia confirmed using metagenomic next-generation sequencing (mNGS). Methods:A total of 26 patients with Chlamydia psittaci pneumonia admitted to the Huizhou Municipal Central People′s Hospital and Huizhou First People′s Hospital from January 2020 to December 2021 were enrolled. The clinical data were collected, including basic information, clinical manifestations, laboratory examinations, chest computed tomography (CT) findings, mNGS results, treatment outcomes and prognosis. Results:Twenty (76.9%) of the 26 cases with Chlamydia psittaci pneumonia had a definite bird or poultry contact history. The onset season was mostly in winter (57.7%, 15/26). All 26 cases had symptoms of high fever, chill, fatigue, anorexia and cough, 21 cases (80.8%) had dyspnea, 19 cases (73.1%) had relative infrequent pulse, 12 cases (46.2%) had headache, myalgia, and seven cases (26.9%) had disturbance of consciousness. Among the 26 cases, the white blood cell count was normal in 17 cases (65.4%), and the lymphocyte count was decreased in 21 cases (80.8%). All 26 cases had increased hypersensitive C-reactive protein and procalcitonin. D-dimer was elevated in 24 cases (92.3%), aspartate aminotransferase was elevated in 18 cases (69.2%), and alanine aminotransferase was elevated in 15 cases (57.7%). Chest CT mainly showed lung consolidation, and 20 cases (76.9%) had multiple lobes of the lungs involved, 18 cases (69.2%) had the lower lobe of the lung as the main lesion. Among the results of mNGS of 26 cases, nine cases (34.6%) had only Chlamydia psittaci detected, and 17 cases (65.4%) had other pathogenic microorganisms detected. After targeted anti-infection treatment, two cases died of multiple organ failure and the remaining 24 patients recovered. Conclusions:The common manifestations of Chlamydia psittaci pneumonia are high fever, dyspnea, relative bradycardia, normal white blood cell count, and lung consolidation. mNGS is helpful for early diagnosis of disease, and appropriate treatment can improve the prognosis.