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:	Li Sun, Pulin Li, Bo Pang, Peipei Wu, Ran Wang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	gestational psittacosis hemophagocytic syndrome metagenomic next-generation sequencing gestational psittacosis with secondary hemophagocytic syndrome long-term high fever Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/097659a8e40749708a80a905daac082b
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spelling	oai:doaj.org-article:097659a8e40749708a80a905daac082b2021-11-18T06:26:54ZGestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review2296-858X10.3389/fmed.2021.755669https://doaj.org/article/097659a8e40749708a80a905daac082b2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.755669/fullhttps://doaj.org/toc/2296-858XGestational 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.Li SunPulin LiBo PangPeipei WuRan WangFrontiers Media S.A.articlegestational psittacosishemophagocytic syndromemetagenomic next-generation sequencinggestational psittacosis with secondary hemophagocytic syndromelong-term high feverMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	gestational psittacosis hemophagocytic syndrome metagenomic next-generation sequencing gestational psittacosis with secondary hemophagocytic syndrome long-term high fever Medicine (General) R5-920
spellingShingle	gestational psittacosis hemophagocytic syndrome metagenomic next-generation sequencing gestational psittacosis with secondary hemophagocytic syndrome long-term high fever Medicine (General) R5-920 Li Sun Pulin Li Bo Pang Peipei Wu Ran Wang Gestational Psittacosis With Secondary Hemophagocytic Syndrome: A Case Report and Literature Review
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.
format	article
author	Li Sun Pulin Li Bo Pang Peipei Wu Ran Wang
author_facet	Li Sun Pulin Li Bo Pang Peipei Wu Ran Wang
author_sort	Li Sun
title	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_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_sort	gestational psittacosis with secondary hemophagocytic syndrome: a case report and literature review
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/097659a8e40749708a80a905daac082b
work_keys_str_mv	AT lisun gestationalpsittacosiswithsecondaryhemophagocyticsyndromeacasereportandliteraturereview AT pulinli gestationalpsittacosiswithsecondaryhemophagocyticsyndromeacasereportandliteraturereview AT bopang gestationalpsittacosiswithsecondaryhemophagocyticsyndromeacasereportandliteraturereview AT peipeiwu gestationalpsittacosiswithsecondaryhemophagocyticsyndromeacasereportandliteraturereview AT ranwang gestationalpsittacosiswithsecondaryhemophagocyticsyndromeacasereportandliteraturereview
_version_	1718424458444668928

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

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