宏基因组二代测序辅助诊断鹦鹉热肺炎的一例

A Case of Psittacosis Pneumonia Diagnosed with the Aid of Second-Generation Sequencing of the Metagenome

摘要: 鹦鹉热衣原体首次分离自鹦鹉，是一种革兰阴性需氧细胞内寄生的微生物。主要是人吸入感染的动物所带病原体后，首先进入肝、脾网状内皮细胞繁殖，之后经过血液循环播散到全身多处脏器。鹦鹉热的临床体征和症状是多种多样的，经常被忽视，病原学培养仅作为其他检查的补充，况且培养需要高水平的生物安全实验室，并不作为实验室的常规检查。早期应用宏基因组二代测序技术(mNGS)检测病原学还是相当重要的，可以依据检测结果及时给予对症治疗。本文介绍的就是一例应用mNGS诊断鹦鹉热衣原体肺炎的病例报道，并希望提高大家对此病的认识。

Abstract: Chlamydia psittaci (C. psittaci) was first found from parrots. It is a gram-negative obligate intracel-lular parasite. The main route of human infection is through the respiratory tract by inhaling ani-mal’s excretion aerosol. After the pathogen is inhaled, C. psittaci first enters reticuloendothelial cells of the liver and spleen to proliferate and then enters the lungs and other organs via the blood-stream. The clinical signs and symptoms of psittacosis are varied, often overlooked. Pathogen cul-ture is generally used as a supplement to other tests and requires a high-level biosafety laboratory, and thus, it is not a routine test in most laboratories. Early diagnosis is critical for C. psittaci pneu-monia using metagenomic next-generation sequencing (mNGS), which can lead to favorable prog-noses via immediate adjustment therapies. Here, we report the case of a patient diagnosing psitta-cosis pneumonia using mNGS and hope to raise clinicians’ awareness of this disease.