Chlamydia pneumoniae pneumonia

Introduction to Chlamydia pneumonia Chlamydia pneumoniae (TWAR strain) (Taiwan isolate TW-183 in 1965 and Washington isolate AR-39 in 1983) is currently a chlamydial species most commonly causing respiratory infections in the clinic. Currently, there is only one serotype, which is strict. Human pathogen, no animal intermediate host. basic knowledge The proportion of illness: the prevalence rate is about 0.5%-5% Susceptible people: children and adults Mode of transmission: spread from person to person through respiratory secretions Complications: endocarditis, myocarditis

Causes of Chlamydia pneumoniae pneumonia

(1) Causes of the disease

Chlamydia pneumoniae (TWAR strain) (Taiwan isolate TW-183 in 1965 and Washington isolate AR-39 in 1983) is currently a chlamydial species most commonly causing respiratory infections in the clinic. Currently, there is only one serotype, which is strict. Human pathogen, no animal intermediate host.

(two) pathogenesis

Chlamydia pneumoniae is inhaled from the upper respiratory tract and invades the mucosa such as the nasopharynx. It first causes invasive lesions of local tissue inflammatory cells. The pathogens multiply in mononuclear macrophages and then spread through the blood. The lesions are more common in the lower respiratory tract such as the lungs. Sexual lesions gradually expanded from the hilar, manifested as lobular and interstitial pneumonia, mostly in the lower part of the lung, accompanied by early inflammatory reaction of the lung, showing polymorphonuclear leukocyte infiltration and fibrinous exudation of alveolar, visible alveolar cavity Full of fluid, alveolar wall and pulmonary interstitial are thickened, edema, hemorrhage and necrosis can occur, lesions can also involve the reticuloendothelial system, inflammation of the liver and small focal necrosis, splenomegaly, sometimes pleurisy, pericardium Inflammation and myocarditis, etc., kidney, nerve and digestive system can also appear lesions, basophilic inclusion bodies can be seen in lung macrophages, myocardium, pericardium and hepatic stellate cells.

Chlamydia pneumoniae prevention

Chlamydia pneumoniae pneumonia is a human respiratory disease that is not related to animal hosts, so it can be prevented by general respiratory infections.

Chlamydia pneumoniae pneumonia complications Complications, endocarditis, myocarditis

Often secondary bacterial infection, combined with endocarditis, myocarditis and so on.

Chlamydia pneumonia pneumonia symptoms Common symptoms Bronchial purulent secretion increased chest pain

Chlamydia pneumoniae infection has an incubation period of 15 to 23 days, can cause upper respiratory tract infections, such as sinusitis, otitis media and pharyngitis, can also cause lower respiratory tract infections, but the latter are mainly, such as bronchitis and pneumonia, Chlamydia pneumoniae pneumonia Chlamydia The main form of infection is different from parrot fever pneumonia. The patient has no history of exposure to sick birds. Most of the respiratory infections of Chlamydia pneumoniae are sore throat, fever, cough (dry cough), chest pain, headache, discomfort and fatigue, and involvement. The lobes of the lungs can be heard, but the re-infected patients tend to have less respiratory symptoms and less develop pneumonia. The clinical manifestations of elderly patients with Chlamydia pneumoniae may be more serious, sometimes fatal, especially with bacterial infections. Or when there are underlying diseases such as chronic obstructive pulmonary disease.

Examination of Chlamydia pneumoniae pneumonia

Chlamydia culture, take nasopharyngeal or posterior pharyngeal swab, trachea and bronchial aspirate, alveolar lavage fluid and other specimen culture.

Microimmunofluorescence test (MIF): It is the internationally accepted and most commonly used serological diagnosis method for Chlamydia pneumoniae. In addition to STD clinic patients and specific populations, MIF serological diagnosis of Chlamydia pneumoniae pneumonia can use single antigen of Chlamydia pneumoniae. , that is, there is no need to simultaneously detect Chlamydia trachomatis and Chlamydia psittaci antibody, the serological diagnostic criteria are: MIF test IgG 1: 512 and / or IgM 1: 32, in 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, and 1:16 IgG < 1: 512 is a previous infection.

X-ray chest X-ray: The main manifestation is unilateral alveolar infiltration, which can progress to bilateral interstitial and alveolar infiltration. Chlamydia pneumoniae infection recurrence is more common, especially when antibiotic treatment is inadequate, but less involving organs outside the respiratory system.

Diagnosis and identification of pneumonia pneumonia

The clinical symptoms and X-ray findings of Chlamydia pneumoniae lung infection are non-specific and cannot be distinguished from other atypical pneumonia, especially Mycoplasma pneumoniae pneumonia. Therefore, the diagnosis depends on laboratory diagnosis. The most reliable method is to culture Chlamydia pneumoniae. Take nasopharyngeal or posterior pharyngeal swabs, trachea and bronchial aspirate, alveolar lavage fluid and other specimen cultures. Recently, specimens treated with trypsin and/or sodium edetate (EDTA) have been reported. The isolation rate of Chlamydia is greatly improved, and the isolate can be identified by the monoclonal antibody specific to Chlamydia pneumoniae. However, due to the high culture requirements of Chlamydia pneumoniae, it is difficult to do in general laboratories. It is helpful to use the PCR test to detect the above specimens. However, 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 pneumoniae. In addition to STD clinic patients and specific populations, Chlamydia pneumoniae MIF serological diagnosis of pneumonia can use a single antigen of Chlamydia pneumoniae, ie no simultaneous detection of trachoma Protoplast and Chlamydia psittaci antibody, serological diagnostic criteria: MIF test IgG 1: 512 and / or IgM 1: 32, can be diagnosed as a recent infection after the exclusion of false positives caused by rheumatoid factor (RF) A double-dose serum antibody titer of 4 times or more was also diagnosed as a recent infection, and 1:16 IgG < 1: 512 was a previous infection.

Attention should be paid to the identification of mycoplasmal pneumonia and viral pneumonia. The clinical symptoms and chest X-ray changes of these two types of pneumonia are very similar to those of Chlamydia pneumoniae. The differential diagnosis depends on laboratory tests.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.