An unusual presentation of a case of human psittacosis

Weygaerde, Yannick Vande; Versteele, Charlot; Thijs, Elke; Spiegeleer, Anton De; Boelens, Jerina; Vanrompay, Daisy; Braeckel, Eva Van; Vermaelen, Karim

doi:10.1016/j.rmcr.2018.01.010

Cited by 24 publications

(23 citation statements)

References 23 publications

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“…Pulmonary auscultation is ineffective and often inconsistent with severe clinical manifestations. Laboratory analysis shows that the white blood cell count in patients with C. psittaci pneumonia is significantly lower compared with other pneumonia types [25]. In the current study, the average white blood cell count was normal, however, the CRP levels were significantly higher compared with the normal value.…”

Section: Discussioncontrasting

confidence: 67%

Application of metagenomic next-generation sequencing in the diagnosis of severe pneumonia caused by Chlamydia psittaci

Ling

Fang

2021

BMC Pulm Med

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Purpose Psittacosis is a zoonotic infectious disease caused by the transmission of the bacterium Chlamydia psittaci (C. psittaci) from birds to humans. Infections in humans mainly present as community-acquired pneumonia (CAP). However, most cases are treated without diagnostic testing, and the importance of Chlamydia psittaci infection as a cause of CAP is therefore unclear. Diagnostic tools, including culture, serologic test, and PCR-based methods, are available but prone to false negative results. Metagenomic next-generation sequencing (mNGS) has been increasingly used in the diagnosis of infectious diseases, particularly when conventional diagnostic approaches have limitation. Detection of nucleic acid sequence of C. psittaci in respiratory tract samples by metagenomic next-generation sequencing (mNGS) is effective for early diagnosis of severe C. psittaci pneumonia. Timely treatment based on tetracycline can reduce unnecessary use of antibiotics and improve prognosis of patients with severe C. psittaci pneumonia. Methods Clinical data of thirteen patients with severe C. psittaci pneumonia diagnosed by mNGS were collected. Clinical manifestations, treatment and prognosis of patients were summarized. Results The typical symptoms of pneumonia caused by C. psittaci include fever, headache, myalgia, cough, and dyspnea. In the current study, all patients met the criteria for severe C. psittaci pneumonia and received mechanical ventilation, including noninvasive mechanical ventilation (five/thirteen) and invasive mechanical ventilation (eight/thirteen). The findings showed that patients with C. psittaci pneumonia presented with normal or slightly increased leucocytes and procalcitonin, and high C-reactive protein levels. Computed tomography manifestations included consolidation of lung parenchyma, with air bronchogram and pleural effusion in some patients. mNGS analysis results were obtained within 48–72 h. Eleven patients fully recovered after targeted treatment, however, two patients died from secondary multidrug-resistant Pseudomonas aeruginosa infection. Conclusions The findings of the current study show that mNGS is effective in diagnosis of C. psittaci pneumonia, and has significant diagnosis value in patients with severe infection. Patients responds well to the timely use of appropriate antibiotics.

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Section: Discussioncontrasting

confidence: 67%

Application of metagenomic next-generation sequencing in the diagnosis of severe pneumonia caused by Chlamydia psittaci

Ling

Fang

2021

BMC Pulm Med

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“…In 1985, an outbreak of psittacosis affected employees at a duck processing plant in the United Kingdom [6]. Nowadays psittacosis cases are usually limited to local outbreaks, small clusters or isolated cases [7][8][9][10][11][12][13][14][15][16][17]. Community-acquired pneumonia (CAP) is the most important presentation of human psittacosis, but microbiological testing for psittacosis in a pneumonia patient is often not incorporated in routine diagnostics.…”

Section: Introductionmentioning

confidence: 99%

Animal sources for zoonotic transmission of psittacosis: a systematic review

et al. 2020

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Background: Human psittacosis, caused by Chlamydia (C.) psittaci, is likely underdiagnosed and underreported, since tests for C. psittaci are often not included in routine microbiological diagnostics. Source tracing traditionally focuses on psittacine pet birds, but recently other animal species have been gaining more attention as possible sources for human psittacosis. This review aims to provide an overview of all suspected animal sources of human psittacosis cases reported in the international literature. In addition, for each animal species the strength of evidence for zoonotic transmission was estimated. Methods: A systematic literature search was conducted using four databases (Pubmed, Embase, Scopus and Proquest). Articles were included when there was mention of at least one human case of psittacosis and a possible animal source. Investigators independently extracted data from the included articles and estimated strength of evidence for zoonotic transmission, based on a self-developed scoring system taking into account number of human cases, epidemiological evidence and laboratory test results in human, animals, and the environment. Results: Eighty articles were included, which provided information on 136 different situations of possible zoonotic transmission. The maximum score for zoonotic transmission was highest for turkeys, followed by ducks, owls, and the category 'other poultry'. Articles reporting about zoonotic transmission from unspecified birds, psittaciformes and columbiformes provided a relatively low strength of evidence. A genotypical match between human and animal samples was reported twenty-eight times, including transmission from chickens, turkeys, guinea fowl, peafowl, pigeons, ducks, geese, songbirds, parrot-like birds and owls. Conclusions: Strong evidence exists for zoonotic transmission from turkeys, chickens and ducks, in addition to the more traditionally reported parrot-like animal sources. Based on our scoring system, the evidence was generally stronger for poultry than for parrot-like birds. Psittaciformes should not be disregarded as an important source of human psittacosis, still clinicians and public health officials should include poultry and birds species other than parrots in medical history and source tracing.

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“…Antibiotic treatment in C. suis -induced conjunctivitis as a single finding is uneconomical and usually not carried out due to the associated compliance with the withdrawal time. Lack of seroconversion in a human case of psittacosis has also been described recently [ 39 ]. The route of infection might play a crucial role, since genital experimental C. suis S45 infections in sows led to an evident seroconversion, detected by an ELISA using purified S45 elementary bodies (EBs) as the antigen [ 36 ]: C. suis S45-specific serum IgM and IgG were observed from seven days post-primary infection onwards, and the mean titres peaked at 14 or 21 days post-infection.…”

Section: Discussionmentioning

confidence: 84%

Characteristics of Chlamydia suis Ocular Infection in Pigs

et al. 2021

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Chlamydia (C.) suis can often be isolated from conjunctival swab specimens from pigs with conjunctivitis or keratoconjunctivitis. In the field, it is assumed to be a multifactorial disease triggered by immunosuppressing factors. This is the first experimental study to provoke clinical signs of conjunctivitis in pigs after C. suis primary mono-infection. Five six-week-old male piglets, free of ocular chlamydia shedding and seronegative for Chlamydia, were conjunctivally infected with the C. suis-type strain S45 (1 × 109 inclusion forming units), while four piglets served as negative controls. The infection group developed clinical signs of conjunctivitis with a peak in the first week post-infection. Immunohistochemical evaluation revealed the presence of Chlamydia not only in the conjunctival epithelium, but also in the enlarged lacrimal glands, lungs, and intestine. No circulating antibodies could be detected during the whole study period of three weeks, although three different test systems were applied as follows: the complement fixation test, MOMP-based Chlamydiaceae ELISA, and PmpC-based C. suis ELISA. Meanwhile, high numbers of IFN-γ-producing lymphocytes within PBMC were seen after C. suis re-stimulation 14 days post-infection. Hence, these data suggest that entry via the eye may not elicit immunological responses comparable to other routes of chlamydial infections.

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An unusual presentation of a case of human psittacosis

Cited by 24 publications

References 23 publications

Application of metagenomic next-generation sequencing in the diagnosis of severe pneumonia caused by Chlamydia psittaci

Application of metagenomic next-generation sequencing in the diagnosis of severe pneumonia caused by Chlamydia psittaci

Animal sources for zoonotic transmission of psittacosis: a systematic review

Characteristics of Chlamydia suis Ocular Infection in Pigs

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