A woman from Zhejiang has a high fever of 39℃, and she can't walk!

Recently, a person died after being infected. The doctor urgently reminded...

　　"Weakness, fever, and chest tightness that can't be cured for a long time are actually related to watching others kill ducks?" Sister Geng (pseudonym), who escaped from the dead, was full of grievances and perplexity when talking about the misfortune that happened some time ago.

However, the doctor put an end to the painful days, and she was still very excited and grateful.

She is in good health and she suddenly has chest tightness and shortness of breath, so she can't walk

　　Sister Geng, who is nearly 50 years old, lives in a rural village in north-central Zhejiang and has always been in good health.

The strange thing is that she suddenly suffered from general fatigue. At first she thought it was overwork, and she would get better with rest, but after 1 week of rest, not only did the fatigue not improve, but it became more serious.

　　Gradually, Sister Geng couldn't even walk, she also developed a severe dry cough, accompanied by fever, and her body temperature reached a maximum of 39.2°C.

Sister Geng went to the local hospital but did not improve after a few days of treatment, so she was transferred to Zhejiang Provincial People's Hospital.

　　When Sister Geng arrived in the emergency room, her chest tightness and shortness of breath were obvious, the oxygen saturation was not high under oxygen inhalation, and the inflammation index C-reactive protein was as high as 327.7 mg/L... Related blood tests showed that the liver, kidneys, and muscles were all damaged. A CT scan of the lungs showed multiple diffuse lesions in both lungs. The emergency doctor considered the patient in critical condition and the etiology was unknown, so he hurriedly invited an infectious disease doctor for consultation.

She saw someone slaughter a duck 10 days ago, and she got the trick

　　Deputy Chief Physician Wang Guoyun of the Department of Infectious Diseases inquired about the medical history and believed that the patient had an acute onset, rapid lung progression, multiple lobe lesions, and low oxygenation, which was in line with "severe pneumonia."

However, the strange thing is that after admission, the relevant routine examinations including influenza virus, respiratory virus, and Mycoplasma pneumoniae were all negative. Although the empirical anti-infection treatment was supplemented with high-flow oxygen inhalation, the lung CT showed lungs after a few days. The lesion has progressed significantly than before.

　　"It is not like ordinary bacterial pneumonia from imaging studies, accompanied by multiple organ damage, and there is still significant progress in lung lesions under conventional anti-infective treatment. It is necessary to consider the possibility of atypical pathogen infection." Pan Hongying, director of the Department of Infectious Diseases and his Team members: Chief physician Tong Yongxi, deputy chief physician Wang Guoyun, attending physicians Huang Yicheng, and Zheng Wei decided to trace the root cause and further inquire about the medical history. They finally discovered the cause: Sister Geng had seen someone kill ducks about 10 days before the onset of illness, and stayed for a while. ...Have a history of exposure to live poultry, so be wary of the possibility of zoonotic diseases.

　　As expected, the results of metagenomic second-generation sequencing (mNGS) of the alveolar lavage fluid detected the nucleic acid sequence of Chlamydia psittaci, and Sister Geng was eventually diagnosed as "psittaci."

　　Find the cause, and the treatment can prescribe the right medicine.

The medical team immediately adjusted the treatment plan. After the doxycycline injection combined with moxifloxacin injection for anti-infection, the patient's body temperature quickly returned to normal, chest tightness and shortness of breath were significantly improved, and the lung CT showed obvious absorption of the lesion.

People who have frequent contact with birds and poultry should pay attention

　　Director Pan Hongying introduced that psittacosis, also known as "bird disease", is transmitted to people by birds and ducks that carry Chlamydia psittaci. The disease was first discovered to be more common in parrot viewers, so it was named psittacosis.

In recent years, relevant foreign literature reports that Chlamydia psittaci pneumonia accounts for about 1% of community-acquired pneumonia, which needs to arouse everyone's vigilance.

　　"It is generally believed that chlamydia or infectious aerosols mixed in dust can cause inhalation infections through the respiratory tract; while contact with infected birds or poultry and their contaminated secretions, excreta, etc., can cause damage to the skin or mucous membranes and digestive tract. And other ways to get the infection."

　　Director Pan Hongying said that after Chlamydia psittaci invades the human body, the incubation period is generally 7-15 days, the shorter is 3 days, and the longest can be up to 45 days.

The clinical manifestations of Chlamydia psittaci pneumonia lack specificity. The common symptoms are high fever, chills, severe headache, myalgia, dry cough, dyspnea, and gastrointestinal reactions. It is prone to involvement of extrapulmonary organs. In severe cases, it is life-threatening. In Lishui, Zhejiang, there was a case of ineffective treatment and death).

　　Tetracyclines are the first choice for the treatment of Chlamydia psittaci infection, followed by macrolides.

Fluoroquinolones are effective against Chlamydia psittaci, but they may not be as effective as tetracyclines and macrolides.

The course of treatment is at least 10-14 days, and extending the course of treatment to 2-3 weeks can reduce recurrence.

　　Director Pan reminded that people who have frequent close contact with birds and poultry are at high risk of Chlamydia psittaci infection.

Bird lovers should pay attention to maintaining the hygiene of the bird breeding environment, clean the bird cage daily, wear masks and gloves when cleaning the feces, and advocate the use of "wet work" to prevent pathogenic microorganisms from spreading into the air and being inhaled into the human body. Infection; keep a distance when buying live poultry, and cook thoroughly when eating poultry.

If poultry develop symptoms of psittacosis, they should be isolated immediately and the sick poultry should be dealt with in time.

If a person develops corresponding symptoms, they should seek medical attention immediately.

　　Qianjiang Evening News · Hour News Correspondent Song Lisheng and reporter Wu Chaoxiang