What Is Chlamydia Pneumonia?

Chlamydia pneumonia is pneumonia caused by Chlamydia. Chlamydia is divided into Chlamydia trachomatis (CT), Chlamydia pneumoniae (CP), Chlamydia psittaci, and Chlamydia fumigatus. CP is the cause of pneumonia, and occasionally Chlamydia psittaci pneumonia. Chlamydia pneumoniae pneumonia is more common in school-age children, most of them are mild, and the disease is often hidden. There is no gender difference in the infection rate, and it can occur in all seasons.

Basic Information

English name: chamydiae pneumonia
Visiting department: Respiratory Medicine
Multiple groups: School-age children
Common causes: Caused by chlamydia infection

Common symptoms: Fever, chills, myalgias, dry cough, non-pleural inflammatory chest pain, headache, discomfort and fatigue
Contagious: Have
way for spreading: Person-to-person transmission through respiratory secretions

Causes of Chlamydia pneumoniae pneumonia

Human Chlamydia pneumoniae infection is universal in the world. Chlamydia pneumoniae is transmitted from person to person through respiratory secretions. As a result, small-scale epidemics may exist in semi-enclosed environments such as homes, schools, the military, and other populated work areas. Chlamydia pneumoniae infection may also be related to the onset of asthma, coronary heart disease and atherosclerosis, the acute onset and exacerbation of chronic obstructive pulmonary disease. At present, Chlamydia pneumoniae is the main pathogen that causes community-acquired pneumonia after Pneumococcus pneumoniae and Haemophilus influenzae. It has become three atypical pathogens of community-acquired pneumonia together with Legionella pneumoniae and Mycoplasma pneumoniae, accounting for community-acquired pneumonia. 10% to 20% of pneumonia.

Clinical manifestations of Chlamydia pneumoniae pneumonia

Onset is mostly hidden, with early symptoms of upper respiratory tract infection. It is clinically similar to mycoplasma pneumonia. Symptoms are usually mild, fever, chills, myalgia, dry cough, non-pleural inflammatory chest pain, headache, discomfort, and fatigue. Rarely hemoptysis. Those with pharyngitis present with sore throat and hoarseness, and some patients may have a two-stage course: they begin with pharyngitis, and after symptomatic treatment improves, pneumonia or bronchitis occurs after 1 to 3 weeks, and the cough worsens. Chlamydia pneumoniae infection can also be accompanied by extrapulmonary manifestations, such as otitis media, arthritis, thyroiditis, encephalitis, and Guillain-Barre syndrome. Physical examination of the lungs occasionally heard wet rales.

Chlamydia pneumoniae pneumonia examination

Laboratory inspection

(1) The results of white blood cell count and classification are usually normal, but most of the erythrocyte sedimentation rate increases.

(2) Culture of Chlamydia pneumoniae Take nasopharyngeal or posterior pharyngeal wall swabs, trachea and bronchial secretions, alveolar lavage fluid and other specimens for culture.

(3) The micro-immunofluorescence test (MIF) is currently the international standard and the most commonly used serological diagnostic method for Chlamydia pneumoniae. Except for STD outpatients and prostitutes, the MIF serological diagnosis of Chlamydia pneumonia can use Chlamydia pneumoniae. A single antigen, ie, it is not necessary to detect both Chlamydia trachomatis and Chlamydia psittaci antibodies at the same time. Serological diagnostic criteria are: MIF test IgG 1: 512 and / or IgM 1: 32. After excluding false positives caused by rheumatoid factor (RF), a recent infection can be diagnosed. Double serum antibody titers 4 A fold or more increase was also diagnosed as a recent infection. 1: 16IgG <1: 512 is a previous infection.

2. Other auxiliary inspections

X-ray chest radiographs are mainly manifested as unilateral alveolar infiltration, which can later progress to bilateral interstitial and alveolar infiltration.

Diagnosis of Chlamydia pneumoniae pneumonia

The clinical symptoms and X-ray findings of Chlamydia pneumoniae lung infections are non-specific and cannot be distinguished from other atypical pneumonias, especially Mycoplasma pneumoniae pneumonia, so the diagnosis depends on laboratory diagnosis. The most reliable method is to culture Chlamydia pneumoniae, taking nasopharyngeal or posterior pharyngeal wall swabs, trachea and bronchial secretions, alveolar lavage fluid and other specimens. However, due to the high culture requirements of Chlamydia pneumoniae, it is difficult for general laboratories to do so. The detection of the above specimens using PCR tests is very helpful for diagnosis, but attention needs to be paid to quality control to prevent false positive results.

The micro-immunofluorescence test (MIF) is currently the international standard and the most commonly used serological diagnosis method for Chlamydia pneumoniae.

Complications of Chlamydia pneumoniae pneumonia

Often secondary to bacterial infections, combined with endocarditis and myocarditis.

Chlamydia pneumoniae pneumonia treatment

Antibiotic treatment

The preferred treatment is erythromycin, or doxycycline. In recent years, clarithromycin and azithromycin have also been reported to treat Chlamydia pneumoniae infections. Among them, azithromycin has a better effect than clarithromycin, but there is little clinical application experience. Chlamydia pneumoniae is also sensitive to fluoroquinolones, such as ofloxacin or tofloxacin can be used in the treatment of adult patients, but not recommended for children.

2. Notes

The antibiotic course must be adequate to prevent recurrence. If the dose of erythromycin is too small, or the duration of treatment is too short, symptoms such as general discomfort and cough often persist for months.

Prognosis of Chlamydia pneumoniae pneumonia

Without treatment, it usually heals gradually after a few weeks. But the lesions seen in the lungs and the X-rays will not go away for months. Elderly patients or patients with certain chronic diseases, such as patients with COPD or patients with secondary pulmonary bacterial infections, have a poor prognosis.