Chlamydia trachomatis pneumonia
Introduction
Introduction to Chlamydia trachomatis pneumonia Chlamydia trachomatis pneumonia is an inflammation of the lung caused by Chlamydia trachomatis. Chlamydia trachomatis is primarily the cause of human trachoma and reproductive system infections, and can even cause lung infections in neonatal and adult immunosuppressed individuals. The incidence rate is more common in 18 to 30 years old. Neonatal pneumonia is mainly seen in newborns and infants from 2 to 12 weeks. Most of them have no fever. The initial symptoms are usually rhinitis, nasal mucus secretions and nasal congestion. Adult immunosuppressive patients may have respiratory infections such as pharyngitis, bronchitis and pneumonia, which may include dry cough, fever, myalgia, chills, hemoptysis and chest pain. basic knowledge The proportion of illness: 0.002% - 0.004% Susceptible people: no special people Mode of infection: contact spread Complications: conjunctivitis myocarditis
Cause
Chlamydia trachomatis pneumonia
Causes:
The pathogen is Chlamydia trachomatis, chlamydia pneumonia is pneumonia caused by Chlamydia, chlamydia has Chlamydia trachomatis (CT), Chlamydia pneumoniae (CP) Chlamydia psittaci and Chlamydia hominis. Closely related to humans are CT and CP, and occasionally, Chlamydia psittaci pneumonia.
Pathogenesis:
Chlamydia trachomatis includes 15 serotypes, causing human trachoma (A, B, Ba and C), sexually transmitted lymphogranuloma (11, 12 and 13), inclusion body conjunctivitis, genital tract infection (this is considered in developed countries) The most common sexually transmitted diseases), as well as neonatal pneumonia (DK serotype), Chlamydia trachomatis male reproductive tract infections mainly manifested as non-gonococcal urethritis, epididymitis, Reiter syndrome; female manifested as cervicitis, endometritis And pelvic inflammatory disease, the fetus infected by Chlamydia trachomatis at birth can infect neonatal pneumonia and neonatal inclusion body conjunctivitis. In rare cases, Chlamydia trachomatis also causes respiratory infections in immunocompromised adult patients, even in normal adult communities. Acquired pneumonia.
Prevention
Chlamydia trachomatis pneumonia prevention
Pregnant women with Chlamydia trachomatis genital infection, prenatal treatment is the best way to prevent neonatal infection, erythromycin is not toxic to the fetus, can be used for treatment, can also use ethyl erythromycin erythromycin, after birth Immediately apply erythromycin eye ointment to prevent conjunctivitis; if asymptomatic, chest fluoroscopy should be performed at the third week after birth to exclude chlamydial subclinical pneumonia in infants and young children.
Complication
Chlamydia trachomatis pneumonia complications Complications conjunctivitis myocarditis
Conjunctivitis, myocarditis, etc.
Symptom
Chlamydia trachomatis symptoms of pneumonia Common symptoms Nasal congestion, cough, chills, shortness of breath, pulmonary infection, pleural effusion, chest pain, muscle pain, lung vocal hemoptysis
Chlamydia trachomatis neonatal pneumonia is mainly seen in newborns and infants from 2 to 12 weeks, most of them have no fever, the initial symptoms are usually rhinitis, nasal mucus secretions and nasal congestion, and then develop into intermittent cough, shortness of breath, audible And lung voice, may be associated with myocarditis and pleural effusion, half of children may be associated with acute inclusion body conjunctivitis, adult immunosuppressive patients may see pharyngitis, bronchitis and pneumonia and other respiratory infections, may have dry cough, fever, muscle Pain, chills, hemoptysis and chest pain, X-rays of the lungs show interstitial infiltration, bronchial pneumonia or reticular, nodular shadows.
Examine
Examination of Chlamydia trachomatis pneumonia
The most reliable method for chlamydia culture is to culture Chlamydia trachomatis, take nasopharyngeal or posterior pharyngeal swab, trachea and bronchial aspirate, alveolar lavage fluid and other specimen culture, neonatal Chlamydia trachomatis pneumonia can take conjunctival scraping Chlamydia trachomatis can be detected by direct culture and/or smear direct fluorescence (DFA), and the isolate can be identified by a monoclonal antibody specific to Chlamydia trachomatis.
The use of PCR tests to test the above specimens is very helpful for diagnosis, but attention should be paid to quality control to prevent false positive results.
Microimmunofluorescence assay (MIF) is currently the internationally accepted and most commonly used serological diagnosis method for Chlamydia trachomatis, especially for the diagnosis of Chlamydia trachomatis pneumonia in neonates and infants, because high levels of serum can be detected in children. Non-parental IgM antibodies (not through the placental barrier), serological diagnostic criteria: MIF test IgG 1: 512 and / or IgM 1: 32, can be diagnosed after the exclusion of false positives caused by rheumatoid factor (RF) For recent infections, a double-dose serum antibody titer of 4 or more increases was also diagnosed as a recent infection.
X-rays of the lungs showed interstitial infiltration, as well as bronchial pneumonia or reticular, nodular shadows.
Diagnosis
Diagnosis and identification of Chlamydia trachomatis pneumonia
Diagnostic criteria
The clinical symptoms and X-ray findings of Chlamydia trachomatis infection are not specific, so the diagnosis depends on laboratory diagnosis.
1. The most reliable method is to culture Chlamydia trachomatis, take nasopharyngeal or posterior pharyngeal swab, trachea and bronchial aspirate, alveolar lavage fluid and other specimen culture, neonatal Chlamydia trachomatis pneumonia can take conjunctival scraping at the same time Chlamydia trachomatis can be detected by direct culture and/or smear direct fluorescence (DFA), and the isolate can be identified by a monoclonal antibody specific to Chlamydia trachomatis.
2. The application of PCR test to the above specimens is very helpful for diagnosis, but attention should be paid to quality control to prevent false positive results.
3. Microimmunofluorescence assay (MIF) is currently the internationally accepted and most commonly used serological diagnosis method for Chlamydia trachomatis, especially for the diagnosis of Chlamydia trachomatis pneumonia in newborns and infants, because it can detect the presence of high serum in children. Level of non-parental IgM antibody (not through the placental barrier), serological diagnostic criteria: MIF test IgG 1: 512 and / or IgM 1: 32, after the exclusion of rheumatoid factor (RF) caused by false positive It can be diagnosed as a recent infection, and a double-dose serum antibody titer of 4 times or more is also diagnosed as a recent infection.
Differential diagnosis
The disease should be differentiated from viral pneumonia or mycoplasmal pneumonia.
