PMC10289095_01
Chest computed tomography scans on the 0th day of hospitalization in the local hospital (A and B). CT scans showed patchy high-density shadows with blurred margins in both the posterior segment of the left upper lung and the dorsal segment of the lower lung.
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A chest computed tomography (CT) scan demonstrated patchy high-density shadows with blurred margins present in both the posterior segment of the left upper lung and the dorsal segment of the lower lung, which is indicative of pan-lobar pneumonia (Figure 1).
The clinical course of the patient with Chlamydia abortus infection. (A) Antibiotic application during hospitalization. (B) The types of ventilation in the clinical course. (C-G) The changes of procalcitonin, PO2/FiO2, IL-6, IL-8 and IL-10 on each day.
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The clinical course of the patient is depicted in Figure 2.  
Diagnosis of Chlamydia abortus infection using mNGS test and following verification using PCR and sanger sequencing. (A) The unique mapping reads of C. abortus was 2246 with 14.99% genome coverage. (B) PCR detected 178 base-pair products in BALF sample with specific primers (for example, Primer 2, forward primer: ACGCTTACACTCTATTTGAGAAGCT, reverse primer: GCAGCGTTCACAGTGATGTCTT). (C) NCBI sequence alignment result. The "Query" lines indicate the sanger sequencing result of the PCR product, and the "Sbjct" lines show the reference sequence from NCBI database. The identity between the sequence obtained from Sanger sequencing and a reference C. abortus sequence (GenBank accession no. CP031646.1) was 100%.
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BALF (Figure 3A). Because human infection with C. abortus is rare, it was double-checked by PCR assay with a 178bp validation sequence (Figure 3B). Delightedly, the PCR products were confirmed as C. abortus by sanger sequencing (Figure 3C), which eventually confirmed the diagnosis of C. abortus pneumonia.
Chest X-ray scans on the abnormality in lungs during the VV-ECMO support hospitalization. (A) Chest X-ray on the first day of VV-ECMO showed exudation, consolidation, and bilateral pleural effusion in both lungs, especially in the left lung. (B) Chest X-ray on the third day of VV-ECMO showed the exudation, consolidation, and bilateral pleural effusion were relieving than before.
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There was also a significant improvement in pulmonary infiltrates as observed through chest X-ray (Figure 4), as well as a significant improvement in lung compliance.