临床药师参与 1例鹦鹉热衣原体肺炎病人的抗感染诊治分析

目的 分析1例鹦鹉热衣原体肺炎病人的诊断思路和治疗方案,为临床诊治提供思路.方法 该病例于2019年6月8日至南通大学附属医院急诊就诊,反复追问病史,结合基因检测和相关辅助检查,寻找感染部位和病原体;结合病人基本情况、致病病原体和细菌耐药情况,选择适宜的抗菌药物;通过实验室检查数据和病人临床表现进行药学监护.结果 病人主诉气急伴乏力1周,诊断:肺栓塞;肺部感染;I型呼吸衰竭.经抗感染治疗3d后,两肺散在渗出性病变较前明显进展,抗感染治疗效果不明显,取肺泡灌洗液外送基因检测确诊为鹦鹉热衣原体感染引起的肺炎,经联合米诺环素和莫西沙星抗感染治疗,病人肺部感染得到控制,病情好转.结论 鹦鹉热衣原体感染潜伏期较长,感染后没有特异性的临床表现,反复追问病史及基因检测有助于早期发现该病原体感染;联合米诺环素和莫西沙星治疗鹦鹉热衣原体肺炎疗效明确.

Participated in diagnosis and treatment analysis of anti-infection in one case of patient with Chlamydia psittaci pneumonia

Objective To analyze the diagnosis and treatment plan of one case of chlamydia psittaci pneumonia with rare complications, so as to provide ideas for clinical diagnosis and treatment.Methods The case was admitted to Department of Emergency, the Affiliated Hospital of Nantong University on June 8, 2019. Repeated questioning of the medical history, combined with genetic testing andrelated auxiliary examinations, to look for infected sites and pathogens. Combined with the basic situation of the patient, pathogene, andbacterial resistance, appropriate antibiotic therapy was selected. Pharmaceutical care was conducted through laboratory examination data and clinical symptoms of this patient.Results This patient complained of shortness of breath and fatigue for 1 week, diagnosis: pulmonary embolism; pulmonary infection; type I respiratory failure. After 3 days of anti-infective treatment, the exudative lesions of the two lungs were more advanced than before, the effect of anti-infection treatment was not obvious. The alveolar lavage fluid was takenand sent for genetic testing, confirmed that the pneumonia was caused by chlamydia psittaci. Combined with minocycline and moxifloxacin treatment, the patient pulmonary infection was controlled and the condition improved.Conclusions The incubation period of chla? mydia psittaci infection is long, and there is no specific clinical manifestation after infection, repeat medical history and genetic testingcan help detection of the pathogen early. Combined of minocycline and moxifloxacin is effective in the treatment of Chlamydia psittaci pneumonia.