Chlamydia pneumonia
Introduction
Introduction to Chlamydia pneumonia Chlamydiapneumonia is an acute lung inflammation caused by Chlamydia pneumoniae. Chlamydiapneumoniae is a newly discovered chlamydia that mainly causes respiratory and pulmonary infections. In 1986, Grayeton et al found a chlamydia in the acute respiratory infection of students, which was later discovered in adult respiratory diseases. It was named T. jejuni TWAR-TW strain. It was later proved that the chlamydia was a new species and named Chlamydia pneumoniae. basic knowledge Sickness ratio: 0.05% Susceptible people: no specific population Mode of infection: respiratory transmission Complications: thyroiditis
Cause
Chlamydia pneumonia
Chlamydia infection (90%):
Chlamydia pneumonia is a newly discovered chlamydia that mainly causes respiratory and pulmonary infections. In 1986, Grayeton et al found a chlamydia in the acute respiratory infection of students. Later, it was also found in adult respiratory diseases. It was named T. jejuni TWAR-TW strain. It was later proved that the chlamydia was a new species and was named Chlamydia pneumoniae.
Prevention
Chlamydia pneumonia prevention
Chlamydia pneumoniae often produces upper respiratory tract and respiratory tract infections in children and adults. It is now known that the human chlamydial host may be infected by respiratory secretions from person to person. Children under the age of 5 are rarely infected, children over 8 years old and young people are susceptible to infection, especially in crowded places, such as families, schools, and barracks. It is easy to be prevalent in battalions. It has been confirmed by sero-epidemiological survey that at least 40% of adults have Infected by this chlamydia, most of them are subclinical, and the elderly can be infected again.
Complication
Chlamydia pneumonia complications Complications thyroiditis
May be associated with extrapulmonary manifestations such as erythema nodules, thyroiditis, encephalitis and Guillain-Barré syndrome.
Symptom
Chlamydia pneumonia symptoms Common symptoms Dry cough loss of appetite, low heat, lymphadenopathy, eosinophilia, erythema nodules, nausea, hoarseness, difficulty breathing
1. Chlamydia trachomatis pneumonia
In 1975, people began to report the chlamydia pneumonia in newborns. After the inclusion of purulent sputum in the inclusion body, the disease was mostly transmitted by the infected mother. The eye infection was transmitted to the respiratory tract through the nasolacrimal duct. The symptoms were mostly 2-12 after birth. Week appears, the onset is slow, you can have upper respiratory tract infection first, no fever or occasional low fever, then cough and shortness of breath, often have a wet squeak or sputum sound when inhaling, less exhaled wheezing, chest The tablets showed extensive bilateral interstitial and alveolar infiltration. The hyperinflation sign was more common. Occasionally, the large leaf was solid, the peripheral white blood cell count was normal, and eosinophils increased. The nasopharyngeal swab must be scraped to the epithelial cells. The direct fluorescent antibody test (DFA) and the enzyme immunoassay (EIA) can also be used to detect the nasopharyngeal specimen Chlamydia trachomatis antigen. The diagnostic criteria for serological specific antibodies are 4 times higher than the double serum antibody titer, or IgM>1: 32, IgG>1:512, PCR technology can also be used to directly detect Chlamydia DNA.
2. Parrot Chlamydia pneumonia
It is derived from poultry contact or infected with bird droppings. It is an occupational disease of poultry breeding, selling and slaughtering. Human-to-human infections are rare. Pathogens are excreted and excreted. They can be carried for a long time. The hot chlamydia of the parrot enters the human body through the respiratory tract. Propagation and release of toxins in monocytes, disseminated to the lungs and whole body tissues by blood flow, causing lung sound quality and perivascular cell infiltration, hilar lymph node enlargement, incubation period 6 ~ 14d, the incidence of flu-like symptoms, often 38 ~ 40.5 ° C fever, cough at the beginning of the dry cough, after the phlegm, difficulty breathing or light or heavy, relatively slow pulse, muscle pain, chest pain, loss of appetite, occasional nausea, vomiting, such as systemic infection, may have central nervous system Systemic infection symptoms or myocarditis manifestations, occasionally jaundice, more liver, splenomegaly, need to identify with typhoid, sepsis, chest X-ray examination, from the hilum to the periphery, especially in the lower lung field, there is a little shadow in the middle of the glassy shadow The number of peripheral white blood cells is normal, and the erythrocyte sedimentation rate increases slightly in the early stage of the disease. Chlamydial inclusion bodies can be found in the phagocytic cells of the alveolar exudate. The mild children have fever for 3 to 7 days. Back, the disorder 8 ~~ 14d, 20 ~ 25d severe fever, illness weakened immunity, relapse, reported recurrence rate of 21%, then 10% infection rate.
3. Chlamydia pneumoniae pneumonia
The clinical manifestations of this disease are non-specific, similar to mycoplasmal pneumonia, slow onset, long course, mild symptoms, often accompanied by pharyngitis, laryngitis and sinusitis. After the symptoms of upper respiratory tract subsided, dry and wet voices appeared. Such as bronchitis, pneumonia, cough symptoms can last for more than 3 weeks, white blood cell count is normal, chest radiograph is non-specific, mostly unilateral inferior lobe infiltration, manifested as segmental pneumonia, severe bilateral pneumonia, pathogens Except for Chlamydia trachomatis pneumonia, cell culture from tracheal or nasopharyngeal aspiration, positive for Chlamydia pneumoniae, or fluorescent-conjugated monoclonal antibody against Chlamydia pneumoniae to identify Chlamydia pneumoniae in cell culture, PCR detection of Chlamydia pneumoniae DNA More sensitive, but the throat swab specimen test seems to be less than ideal, not as good as serological detection of Chlamydia pneumoniae specific antibody, micro-immunofluorescence (MIF) test to detect Chlamydia pneumoniae is still the most sensitive, specific IgM antibody 1:16 or IgM antibody 1:512 or antibody titer increased by more than 4 times, and has diagnostic value.
Examine
Examination of chlamydia pneumonia
1. Chlamydia trachomatis pneumonia
Chest radiograph showed extensive bilateral interstitial and alveolar infiltration, hyperinflation sign is more common, occasionally large leaf consolidation, peripheral white blood cell count is generally normal, eosinophilia, from nasopharyngeal swab must be scraped to epithelial cells The direct fluorescent antibody test (DFA) and the enzyme immunoassay (EIA) can also be used to detect the nasopharyngeal specimen Chlamydia trachomatis antigen. The diagnostic criteria for serological specific antibodies are 4 times higher than the double serum antibody titer, or IgM>1 :32, IgG>1:512, PCR technology can also be used to directly detect Chlamydia DNA.
2. Parrot Chlamydia pneumonia
Chest X-ray examination, from the hilum to the periphery, especially in the lower lung field, there is a little shadow in the middle of the ground-glass shadow, the number of peripheral white blood cells is normal, the erythrocyte sedimentation rate is slightly increased in the early stage of the disease, and the phagocytic cells of the alveolar exudate can be examined. See chlamydial inclusion body, mild children with fever 3 to 7d gradually regress, middle disease 8 ~ ~ 14d, severe 20 ~ 25d fever, post-immune immunity weakened, recurrence, reported recurrence rate of 21%, re-infection rate About 10%.
3. Chlamydia pneumoniae pneumonia
The white blood cell count is normal, the chest radiograph is non-specific, mostly unilateral inferior lobe infiltration, showing segmental pneumonia, severe cases of extensive bilateral pneumonia, pathogen examination and Chlamydia trachomatis pneumonia, from the trachea or nasopharyngeal aspirate Cell culture, Chlamydia pneumoniae positive, or fluorescently-conjugated monoclonal antibodies against Chlamydia pneumoniae to identify Chlamydia pneumoniae in cell culture. PCR detection of Chlamydia pneumoniae DNA is more sensitive than culture, but it is not ideal to use throat swab specimens. Serological detection of Chlamydia pneumoniae-specific antibodies, micro-immunofluorescence (MIF) test to detect Chlamydia pneumoniae is still the most sensitive, specific IgM antibody 1:16 or IgM antibody 1: 512 or antibody titer increased more than 4 times, has diagnostic value .
Diagnosis
Diagnosis and diagnosis of chlamydia pneumonia
diagnosis
Diagnosis can be made based on medical history, clinical manifestations, and examination.
Differential diagnosis
Chlamydia pneumonia and streptococcal pneumonia, viral pneumonia, bronchitis and other identification.
Tracheitis is an inflammatory change of the trachea and bronchus caused by infection or non-infectious factors. The secretion of mucus is increased. The activity of respiratory enzymes in the epithelial villus of the trachea is reduced due to the lack of negative ions, which affects the secretion function of the alveoli and the ventilation and exchange of the lungs. Gas function. Clinically, it is characterized by long-term cough, cough or wheezing.
