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目的研究肺炎衣原体(CP)呼吸道感染暴发流行的临床特征及胸部影像学表现。方法15例暴发流行的CP呼吸道感染住院患者(1例为原发病例,14例为医护人员)痰和咽拭子标本,应用聚合酶链反应(PCR)检测CP的DNA,使用微量免疫荧光技术(M IF)检测CP的IgG和IgM抗体,同时对胸部X线和CT表现进行分析。结果本组暴发流行的CP感染患者均有发热,头痛,全身肌肉酸痛,干咳,声音嘶哑,咽痛等症状。咳嗽剧烈时伴有胸痛,其中痰中带血3例(3/15,20%),肺部呼吸音减低或细湿啰音5例(5/15,33%)。PCR检测CP阳性13例(13/15,87%),出现明显肺部影像学表现10例(10/15,67%)。主要影像学表现是:一侧和(或)两侧肺部单发或多发腺泡结节状阴影9例,斑片状阴影2例,片状阴影合并局限性肺气肿1例,无肺门及纵隔淋巴结增大、胸腔积液。结论医护人员CP呼吸道感染的暴发流行具有群体发病,发热、头痛、干咳、咽痛和单发或多发腺泡结节状阴影相同的特征。早期CT检查更能真实地反应病变大小,多少和分布范围。诊断时应与严重急性呼吸综合征(SARS)进行鉴别。
Objective To study the clinical characteristics and chest radiographic findings of outbreak of Chlamydia pneumoniae (CP) respiratory tract infection. Methods Fifteen outpatients (one case of primary case and 14 cases of medical staff) who had outbreaks of CP respiratory infection were sputum and throat swab specimens. The DNA of CP was detected by polymerase chain reaction (PCR) and microinjection immunofluorescence (M IF) to detect CP IgG and IgM antibodies, while chest X-ray and CT findings were analyzed. Results This group of outbreaks of CP infection in patients with fever, headache, muscle soreness, dry cough, hoarseness, sore throat and other symptoms. Severe cough accompanied by chest pain, including bloody sputum sputum in 3 cases (3 / 15,20%), pulmonary breath sounds decreased or fine wet rales in 5 cases (5 / 15,33%). PCR detected positive in 13 cases of CP (13 / 15,87%), significant pulmonary imaging findings in 10 cases (10 / 15,67%). The main imaging findings were: single or multiple pulmonary acinar nodular shadow on one side and / or both sides in 9 cases, patchy shadow in 2 cases, flaky shadow in 1 case with limited emphysema, Door and mediastinal lymph nodes increased, pleural effusion. Conclusion The outbreak of CP respiratory infection in health care workers has the same characteristics of group incidence, fever, headache, dry cough, sore throat and single or multiple acinar nodular shadows. Early CT examination more truly reflect the size of the lesion, how much and distribution. Diagnosis should be distinguished from severe acute respiratory syndrome (SARS).