摘要目的:探讨鹦鹉热衣原体肺炎并发横纹肌溶解的临床特点及诊治要点。方法:报道1例合并横纹肌溶解的鹦鹉热衣原体肺炎。以“鹦鹉热衣原体”或“鹦鹉热”和“横纹肌溶解”为检索词检索中国知网、万方数据库及维普数据库，检索时限为1978年1月至2020年5月。以“psittacosis”或“ Chlamydia psittaci”和“rhabdomyolysis”为检索词检索PubMed数据库，检索时限为1967年1月1日至2020年5月30日。 结果:患者男，64岁，高热、乏力伴肌肉酸痛并气促。胸部CT提示双侧肺炎，病情进展合并横纹肌溶解，行肺泡灌洗液及血标本宏基因组二代测序检测，均检出鹦鹉热衣原体序列。共检索到3篇文献，共11例患者，其中明确合并横纹肌溶解的病例5例且2例无完整资料，另外6例提到合并磷酸激酶升高和肌炎。可分析的病例3例，加上本例共4例，女2例，男2例，年龄分别为66、46、44和64岁。4例患者均有发热，其中3例有 明确的禽类接触史。2例患者起病初期伴明显四肢酸痛且病情进展迅速合并呼吸衰竭，2例患者无明显四肢酸痛且经及时治疗后症状明显改善。4例患者虽经及时抗感染治疗后均治愈出院，未造成不良后果。结论:鹦鹉热衣原体肺炎并横纹肌溶解若未得到及时治疗，则临床预后往往不良，早期诊断可减少病死率。

abstractsObjective:To analyze the clinical characteristics and the diagnosis and treatment of Chlamydia psittaci pneumonia complicated with rhabdomyolysis. Methods:We reported a case of Chlamydia psittaci pneumonia complicated with rhabdomyolysis. We did a literature review on the published reports between January 1978 and May 2020 by searching with the key words of “psittacosis” or “ Chlamydia psittaci” and “rhabdomyolysis” in the PubMed database (time frame: January 1, 1967 to May 30, 2020). Results:Our patient was a 64-year-old male presenting with high-grade fever, fatigue, myalgia and dyspnea. A computed tomographic scan of the chest revealed bilateral pneumonia, which was further complicated with rhabdomyolysis during disease progression. This prompted the metagenomic next-generation sequencing, revealing the sequences of Chlamydia psittaci in both the bronchoalveolar lavage fluid and blood. Of the 11 cases in the 3 literature reports that we retrieved, 5 had concomitant rhabdomyolysis (two of which did not have complete clinical information), and the other 6 cases had myositis complicated with an elevated level of creatine phosphokinase. This yielded 3 cases with complete clinical information for our analysis. We had further incorporated their information with the single case managed within our study site. Two were males and the other 2 were females. The patients were aged 66, 46, 44 and 64 years, respectively. All cases had fever and 3 had a contact history with live poultry. Two cases had myalgia and progressed rapidly into having respiratory failure, and the other 2 cases did not develop myalgia and improved significantly after a timely treatment. All 4 cases were cured and discharged after treatment with appropriate antibiotics. No adverse outcomes were observed. Conclusions:The prognosis of Chlamydia psittaci pneumonia complicated with rhabdomyolysis was poor in case of a delayed treatment. Early diagnosis would help reduce the mortality.