A 69-year-old female patient was admitted to the Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Xuzhou Medical University due to a "cough and fever for eight days". On admission, a coronavirus disease (COVID-19) nucleic acid test was positive, and a chest CT scan showed progressive patchy shadows and consolidation shadows in both lungs. Arterial blood gas analysis showed type Ⅰ respiratory failure. The primary diagnosis was severe community-acquired pneumonia in an older adult without underlying disease. However, oxygen inhalation, steroid, anti-inflammatory, and antibacterial empirical treatment with piperacillin/tazobactam was ineffective. Metagenomic next-generation sequencing of bronchoscopy alveolar lavage fluid showed Chlamydia psittaci(C. psittaci). Severe pneumonia was confirmed, caused by coinfection with severe acute respiratory syndrome coronavirus 2 and C. psittaci. A combination of doxycycline and moxifloxacin significantly improved the targeted and symptomatic treatment of the underlying cause. After discharge, the patient recovered within four weeks of follow-up. Therefore, clinicians should be alert to the possibility of coinfection of C. psittaci in patients already diagnosed with COVID-19.
患者女，69岁，主诉“咳嗽、发热8 d”。入院时新型冠状病毒核酸检测阳性，胸部CT示双肺斑片状影、实变影迅速进展，动脉血气分析示Ⅰ型呼吸衰竭，初步诊断老年人、无基础疾病的重症社区获得性肺炎，给予吸氧、糖皮质激素抗炎、抗生素哌拉西林他唑巴坦经验性治疗效果差。支气管镜BALF宏基因组二代测序（mNGS）示鹦鹉热衣原体。确诊新冠病毒和鹦鹉热衣原体混合感染所致的重症肺炎。改用多西环素联合莫西沙星针对病因目标治疗及对症治疗显著好转。出院后随访4周痊愈。因此，临床诊治新冠感染时需警惕合并鹦鹉热衣原体混合感染。.