流产衣原体会导致反刍动物流产;它也会导致孕妇流产和死胎。然而,它很少引起人类肺炎。这里,我们报告一例由流产梭菌引起的严重社区获得性肺炎。
■入院时,一名74岁的妇女报告说她发烧了,咳嗽,她喉咙里有痰,和呼吸急促10天。在当地医院,她最初被诊断为社区获得性肺炎,并接受哌拉西林-他唑巴坦治疗4天.然而,她的病情恶化了,因此她被转移到我们医院。一到达我们的急诊室,她被诊断出患有严重的社区获得性肺炎,并接受了高流量鼻插管和美罗培南的治疗;然后她被转移到呼吸内科。在那里,尽管继续使用高流量鼻插管和omadacycline治疗,但她的病情继续恶化.24h后紧急气管插管,患者被送往重症监护病房(ICU)接受进一步治疗.ICU的医生再次调整治疗方案,这次使用美罗培南和机械通气;他们还使用了甲基强的松龙,乌司他丁,那洛肝素钙,和人类免疫球蛋白。此外,支气管肺泡灌洗液被送去进行宏基因组下一代测序(mNGS).随后的mNGS表明C.abortus的存在,序列号5072;因此,我们停止了美罗培南,并实施了多西环素和莫西沙星的组合.在ICU治疗8天后,病人的病情好转;然后她被拔管,三天后,转回呼吸内科.呼吸内科医师继续服用多西环素和莫西沙星4天,之后患者出院。一个月后,胸部的重复计算机断层扫描(CT)扫描表明,双肺的病变已被大量吸收。
■C.流产偶尔会导致人类肺炎,很少,严重,危及生命的肺炎.mNGS特别适用于这种不寻常感染的早期检测。多西环素和喹诺酮类药物的组合已被证明对由流产梭菌引起的严重肺炎有效。
UNASSIGNED: Chlamydia abortus causes abortions in ruminants; it can also cause miscarriages and stillbirths in pregnant women. However, it rarely causes pneumonia in humans. Here, we report a case of
severe community-acquired pneumonia caused by C. abortus.
UNASSIGNED: On admission to our hospital, a 74-year-old woman reported that she had had a fever, cough, phlegm in her throat, and shortness of breath for 10 days. In the local hospital, she was initially diagnosed with community-acquired pneumonia and treated with piperacillin-tazobactam for 4 days. However, her condition worsened, and she was therefore transferred to our hospital. On arrival at our emergency department, she was diagnosed with
severe community-acquired pneumonia and treated with a high-flow nasal cannula and meropenem; she was then transferred to the Department of Respiratory Medicine. There, her condition continued to worsen despite continued treatment with the high-flow nasal cannula and omadacycline. After 24 h and emergency tracheal intubation, the patient was sent to the intensive care unit (ICU) for further treatment. The doctors in the ICU again adjusted the treatment, this time to meropenem along with mechanical ventilation; they also instituted methylprednisolone, ulinastatin, nadroparin calcium, and human immunoglobulin. In addition, bronchoalveolar lavage fluid was sent for metagenomic next-generation sequencing (mNGS). Subsequent mNGS suggested the presence of C. abortus, sequence number 5072; we therefore discontinued the meropenem and implemented a combination of doxycycline and moxifloxacin. After 8 days of treatment in the ICU, the patient\'s condition improved; she was then extubated and, 3 days later, transferred back to the respiratory medicine department. The respiratory physician continued to administer doxycycline and moxifloxacin for 4 days, after which the patient was discharged with medication. A month later, a repeat computed tomography (CT) scan of the chest suggested that the lesions in both lungs had been largely absorbed.
UNASSIGNED: C. abortus can occasionally cause pneumonia in humans and, rarely,
severe, life-threatening pneumonia. mNGS is uniquely suited for the early detection of this unusual infection. The combination of doxycycline and quinolones has been shown to be effective in
severe pneumonia caused by C. abortus.