| Objective: The clinical characteristics of pigeon breeder’s lung(PBL)were analyzed to further improve the understanding and diagnosis of PBL diseases.To understand the distribution of microflora in the lower respiratory tract of PBL patients,and to explore the differences in the detection rate of microflora in the lower respiratory tract of PBL patients with different subtypes.Methods: Thirty PBL patients diagnosed in our hospital from December 2020 to December 2022 were collected,and 30 healthy people who underwent physical examination in our hospital during the same period were selected as the control group according to gender and age.A comprehensive analysis was made from clinical manifestations,chest imaging changes,laboratory examination,lung function and other aspects to compare the differences in various indicators between PBL patients and healthy people,and then analyze the clinical characteristics of PBL cases.Detect pathogenic microorganisms in the lower respiratory tract samples of 18 PBL patients through metagenomic next-generation sequencing(mNGS),contrast analysis through different PBL subtypes,and test significance through Fisher exact probability method.Results:Clinical features: Among the 30 PBL patients,there were 18 males(60.0%)and 12females(40.0%),aged 22-76 years.The median duration of disease was 12 months.The breeding time of pigeons ranged from 2 to 30 years,and the median time was 5 years.The breeding population ranged from 10 to 300 pigeons with a median of 40 pigeons.The common clinical manifestations were cough(80.0%),shortness of breath(56.7%),sputum(36.7%),chest tightness or dyspnea(16.7%);The main pulmonary functions were reduced diffusion function(86.7%)and restricted ventilation dysfunction(73.3%).The main imaging manifestations were ground glass shadow(73.3%),mesh shadow(23.3%),honeycomb shadow(13.3%),central lobular nodules(10.0%),emphysema(23.3%)and mediastinal lymph node enlargement(13.3%)in some patients,and interstitial fibrosis in26.7% patients.Compared with the healthy control group,the number of leukocytes,percentage of neutrophils,procalcitonin and erythrocyte deposition were significantly increased in PBL group,while FVC,FVC%,FEV1,FEV1%,FEV1/FVC,DLCO,DLCO% and DLCO/VA were significantly decreased.The top five bacteria genera in the relative abundance of the lower respiratory tract of PBL patients were Prevotella(21.0%),Streptococcus(17.0%),Rotella(11.0%),Neisseria(10.0%)and Veronella(8.0%).The detection rates of Streptococcus,Staphylococcus and Fusobacterium in PBL group with fibrosis were higher than those in PBL patients without fibrosis(P=0.025,P=0.025,P=0.043),while the detection rates of Veronella and Neisseria were lower than those in PBL patients without fibrosis(P=0.013,P=0.043).Conclusion: The diagnosis of PBL is difficult,and the diagnosis should be fully combined with the patient’s antigen exposure history,clinical manifestations,imaging manifestations and lung function.The species structure of PBL’s lower respiratory tract microflora is similar to that of common lower respiratory tract microflora,but the relative abundance of bacteria is different,and the detection rates of some bacteria of different types of PBL are significantly different. |
