Gestational psittacosis: case report and literature review.
Gestational psittacosis: case report and literature review.
复制标题
妊娠期鹦鹉热：病例报告和文献综述。
作者：
S. Hyde;K. Benirschke
在欧洲，鹦鹉热衣原体是绵羊和其他哺乳动物流产的一个相对常见的原因。人类鹦鹉热通常被描述为一种轻度至中度的流感样疾病。如果鹦鹉热是在怀孕期间获得的，它可以表现为一种严重的、进行性的发热性疾病，伴有头痛、弥散性血管内凝血、肝酶检查异常和肾功能受损。仅报告了具有显著母胎发病率和死亡率的病例。从这种疾病中恢复后终止妊娠和适当的抗生素治疗。孕妇直接接触受感染的受孕产品是最常见的传播方式。胎盘组织病理学检查结果提示诊断，包括强烈的急性绒毛间炎，绒毛周围纤维蛋白沉积伴绒毛坏死，合体滋养细胞内有大的不规则嗜碱性胞浆内包涵体。市售的属特异性单克隆抗衣原体抗体可用于快速确诊。在美国，只有两例妊娠鹦鹉热病例以前曾报告。与欧洲的经验相反，这两个病例都与鹦鹉有关。这是第一次报告的情况下，绵羊相关的妊娠鹦鹉热记录在美国。应警告妊娠患者避免接触绵羊及其产品，特别是在春季产羔期间。
In Europe, Chlamydia psittaci is a relatively common cause of abortion in sheep and other mammals. Psittacosis in humans is typically described as a mild-to-moderate flu-like illness. If psittacosis is acquired during pregnancy, it can present as a severe, progressive, febrile illness, with headache, disseminated intravascular coagulation, abnormal liver enzyme studies, and impaired renal function. Only cases with significant fetomaternal morbidity and mortality have been reported. Recovery from this disease follows termination of pregnancy and appropriate antibiotic therapy. Direct exposure of gravid humans to infected products of conception is the most commonly reported mode of transmission. Diagnosis is suggested by the placental histopathologic findings, which consist of an intense, acute intervillositis, perivillous fibrin deposition with villous necrosis, and large irregular basophilic intracytoplasmic inclusions within the syncytiotrophoblast. Commercially available genus-specific monoclonal antichlamydial antibody is available for the rapid confirmation of the diagnosis. In the United States, only two cases of gestational psittacosis have been previously reported. In contrast to the experience in Europe, both cases were associated with psittacine birds. This is the first reported instance of ovine-related gestational psittacosis documented in the United States. Gravid patients should be warned to avoid contact with sheep and their products, particularly during the spring lambing period.