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Gestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review

Gestational psittacosis and hemophagocytic syndrome (HPS) are rare clinical diseases. In this article, a case of gestational psittacosis concomitant with secondary HPS was reported. An analysis was performed on the clinical characteristics, signs, laboratory findings, progression, diagnosis, and tre...

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Autores principales: Sun, Li, Li, Pulin, Pang, Bo, Wu, Peipei, Wang, Ran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636855/
https://www.ncbi.nlm.nih.gov/pubmed/34869453
http://dx.doi.org/10.3389/fmed.2021.755669
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author Sun, Li
Li, Pulin
Pang, Bo
Wu, Peipei
Wang, Ran
author_facet Sun, Li
Li, Pulin
Pang, Bo
Wu, Peipei
Wang, Ran
author_sort Sun, Li
collection PubMed
description Gestational psittacosis and hemophagocytic syndrome (HPS) are rare clinical diseases. In this article, a case of gestational psittacosis concomitant with secondary HPS was reported. An analysis was performed on the clinical characteristics, signs, laboratory findings, progression, diagnosis, and treatment of a patient with gestational psittacosis concomitant with secondary HPS. Besides, the literature with respect to this disease was reviewed. This patient was definitively diagnosed through metagenomic next-generation sequencing techniques, bone marrow puncture and smear examination, and the determination of sCD25 level and natural killer (NK) cell activity. Anti-infectives such as doxycycline and etoposide combined with hormone chemotherapy achieved significant improvement in cough and expectoration, a return to normal temperature, and a significant improvement in oxygenation index. In addition, chest computed tomography revealed obvious absorption of lung lesions and a return of NK cell activity and sCD25 levels to normal ranges. Chlamydia psittaci pneumonia requires a clear determination of etiology, while HPS requires bone marrow puncture and smear examination, together with the determination of sCD25 level and NK cell activity in the blood. The findings of this study suggest that metagenomic next-generation sequencing is an effective instrument in clearly identifying pathogens that cause lung infection. Clinicians should consider atypical pathogens of lung infection in patients with poor response to empirical anti-infectives, and strive to design an effective treatment strategy as per an accurate diagnosis based on the etiology. As for patients suffering from long-term high fever and poor temperature control after broad-spectrum antibiotic treatment, non-infectious fever should be taken into account. A rapid and clear diagnosis would significantly improve patient prognosis.
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spelling pubmed-86368552021-12-03 Gestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review Sun, Li Li, Pulin Pang, Bo Wu, Peipei Wang, Ran Front Med (Lausanne) Medicine Gestational psittacosis and hemophagocytic syndrome (HPS) are rare clinical diseases. In this article, a case of gestational psittacosis concomitant with secondary HPS was reported. An analysis was performed on the clinical characteristics, signs, laboratory findings, progression, diagnosis, and treatment of a patient with gestational psittacosis concomitant with secondary HPS. Besides, the literature with respect to this disease was reviewed. This patient was definitively diagnosed through metagenomic next-generation sequencing techniques, bone marrow puncture and smear examination, and the determination of sCD25 level and natural killer (NK) cell activity. Anti-infectives such as doxycycline and etoposide combined with hormone chemotherapy achieved significant improvement in cough and expectoration, a return to normal temperature, and a significant improvement in oxygenation index. In addition, chest computed tomography revealed obvious absorption of lung lesions and a return of NK cell activity and sCD25 levels to normal ranges. Chlamydia psittaci pneumonia requires a clear determination of etiology, while HPS requires bone marrow puncture and smear examination, together with the determination of sCD25 level and NK cell activity in the blood. The findings of this study suggest that metagenomic next-generation sequencing is an effective instrument in clearly identifying pathogens that cause lung infection. Clinicians should consider atypical pathogens of lung infection in patients with poor response to empirical anti-infectives, and strive to design an effective treatment strategy as per an accurate diagnosis based on the etiology. As for patients suffering from long-term high fever and poor temperature control after broad-spectrum antibiotic treatment, non-infectious fever should be taken into account. A rapid and clear diagnosis would significantly improve patient prognosis. Frontiers Media S.A. 2021-11-18 /pmc/articles/PMC8636855/ /pubmed/34869453 http://dx.doi.org/10.3389/fmed.2021.755669 Text en Copyright © 2021 Sun, Li, Pang, Wu and Wang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Sun, Li
Li, Pulin
Pang, Bo
Wu, Peipei
Wang, Ran
Gestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review
title Gestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review
title_full Gestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review
title_fullStr Gestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review
title_full_unstemmed Gestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review
title_short Gestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review
title_sort gestational psittacosis with secondary hemophagocytic syndrome: a case report and literature review
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636855/
https://www.ncbi.nlm.nih.gov/pubmed/34869453
http://dx.doi.org/10.3389/fmed.2021.755669
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