Severe Chlamydia psittaci Pneumonia Complicated by Rhabdomyolysis: A Case Series

Abstract

Purpose To explore the clinical characteristics, diagnosis, and treatment of severe Chlamydia psittaci pneumonia complicated by rhabdomyolysis and to improve the success rate of treatment. Patients and Methods The clinical characteristics, diagnosis, treatment, and outcomes of four patients with severe C. psittaci pneumonia complicated by rhabdomyolysis diagnosed by metagenomic next-generation sequencing (mNGS) in our hospital were analyzed retrospectively. Results All four patients were male, aged 46–64 years, and all had a history of bird contact. All patients had fever, fatigue, tea-colored urine, myalgia, and two patients were unable to walk. C. psittaci DNA was found by mNGS of the bronchoalveolar lavage fluid of all four patients. Their creatine kinase was >1000 U/L, and myoglobin, C-reactive protein, procalcitonin, and brain natriuretic peptide were significantly increased. The McMahon score of three patients was >6 points, of whom one patient suffered from acute kidney injury; he was treated with continuous renal replacement therapy and eventually died. After diagnosis, three patients were treated with doxycycline and quinolones and were discharged after recovery. Conclusion Psittacosis complicated by rhabdomyolysis is characterized by fever, fatigue, myalgia, and tea-colored urine, with significant increases in creatine kinase and myoglobin. The McMahon score should be applied early to assess the risk of acute kidney injury, and renal replacement therapy and renal protection therapy should be initiated in the early stage. Among severely ill patients, early use of empirical antibiotics, including quinolones, may improve the prognosis.

Clinical features and a prediction model for early prediction of composite outcome in Chlamydia psittaci pneumonia: a multi-centre retrospective study in China

“…The clinical symptoms and signs of C.psittaci pneumonia are usually nonspeci c and mild, but some patients could progress to respiratory failure, rhabdomyolysis, multiple organ failure, and even death [4,5]. According to previous research, provided that patients receive prompt and adequate antibiotic treatment, the mortality rate associated with C. psittaci infection is less than 1% [6].…”

Chlamydia psittaci pneumonia complicated with organizing pneumonia: A case report and literature review

“…Its symptoms include fever, headache, myalgia, dry cough, changes in consciousness, photophobia, hepatosplenomegaly, and pharyngitis [4] . Severe cases may include rhabdomyolysis [5] , severe pneumonia [6] . In this case, the patient did not have other organ dysfunction, but did present with organizing pneumonia, which has been rarely reported.…”

Diagnosis of a Familial Psittacosis Outbreak with Clinical Analysis and Metagenomic Next-Generation Sequencing Under COVID-19: A Case Series

“… 11 The course of C. psittaci can vary from acute to chronic, with clinical presentations ranging from asymptomatic to severe pneumonia. Additionally, patients may have multiple extrapulmonary complications, including acute kidney injury, rhabdomyolysis, and meningitis, 12 , 13 which can be life-threatening if not managed promptly. However, rapid diagnosis of psittacosis in the early disease stages is difficult because of the similarity of the clinical presentation with other common community-acquired pneumonia.…”