Clinical characteristics of Chlamydia psittaci pneumonia

Kong, Chunli; Zhu, Jiaan; Lu, Jingjing; Xu, Zhihao

doi:10.1097/cm9.0000000000001313

Cited by 21 publications

(17 citation statements)

References 5 publications

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“…Mild to moderate pleural effusion on one or both sides was detected in 51.92% of patients, and mild pericardial effusion was documented in 11.54% of patients. The lesions might be progressed to the peripheral and contralateral lobes [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

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Clinical, radiological and pathological characteristics of moderate to fulminant psittacosis pneumonia

Xiao

et al. 2022

PLoS ONE

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Background Psittacosis pneumonia is a community-acquired pneumonia caused by Chlamydia psittaci. It is usually under-diagnosed due to its atypical clinical presentation and lack of routine laboratory tests. Methods To better understand the clinical features, 52 patients diagnosed with psittacosis pneumonia by metagenomic next-generation sequencing (mNGS) were enrolled in this study. The clinical, radiological and pathological characteristics were retrospectively analyzed. Results The onset of psittacosis pneumonia in this study occurred all year round, with a peak from December to January. Most of the patients were 51–80 years old. About 65.38% of patients had a history of exposure to poultry or parrots. Abnormalities of multiple clinical signals were detected in these patients. Elevated levels of neutrophil ratio, C-reactive protein, erythrocyte sedimentation rate, and procalcitonin were detected in most patients. Radiological evidence revealed air-space consolidation or ground-glass opacities in lungs of all patients, which is the typical feature of psittacosis pneumonia. In addition, hyperemia, swelling of bronchial mucosa, and bronchial patency were detected by bronchoscopy in all patients, and bronchial sub-mucosal edema, inflammatory cells infiltration and alveolar epithelial hyperplasia were identified in the bronchial mucosa and alveolar tissue. Beta-lactam antibiotics were administered for empirical treatment before mNGS in 17 patients but showed no improvement. The treatment was switched to doxycycline or moxifloxacin immediately since psittacosis pneumonia were suspected and confirmed by mNGS detection (within 48 hours). After receiving adjustment of treatment, 94.23% (49/52) of patients were cured successfully. Conclusions In conclusion, mNGS may be a promising approach for clinical diagnosis of psittacosis. For patients with a history of exposure to birds, hyperpyrexia, nonproductive cough, multiple elevated inflammatory markers, and air-space consolidation in lung, psittacosis pneumonia should be considered, especially when beta-lactam antibiotics showed limited efficacy.

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Section: Resultsmentioning

confidence: 99%

“…Multiple lobes or both lungs were involved in most of patients with psittacosis pneumonia, the frequency was higher than the previous reports [ 4 ]. In fact, previous studies revealed pneumonia involving single lower lobar lesions was the most frequent in psittacosis pneumonia patients [ 13 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical, radiological and pathological characteristics of moderate to fulminant psittacosis pneumonia

Xiao

et al. 2022

PLoS ONE

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“…Previous studies have shown that C. psittaci pneumonia mainly occurs in the middle-aged and elderly population, with male preponderance, and more than half have a history of bird exposure [ 8 , 10 , 24 ]. Similar to previous studies, our study found that 93.1% of C. psittaci pneumonia patients were > 40 years old, and male patients accounted for the most cases.…”

Section: Discussionmentioning

confidence: 99%

“…Parrot fever was endemic in 12 countries in the 1930s and led directly to the creation of the National Institutes of Health [ 2 ]. The flow of C. psittaci from parrots spread from person to person in a limited way [ 3 – 6 ], and over the past few decades, sporadic outbreaks of C. psittaci have spread from place to place [ 7 – 10 ]. Hogerwerf estimated that the incidence of C. psittaci is at least 1% of the incidence of CAP [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Chlamydia psittaci Pneumonia Infection in Central South China

Yang

et al. 2022

Infect Dis Ther

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Introduction Chlamydia psittaci pneumonia has been a global public health hotspot in recent years. Although some scattered cases of C. psittaci pneumonia have been reported, there is a lack of large case studies worldwide. Methods In this multicenter, observational study, we recruited all consecutive patients with confirmed C. psittaci pneumonia from October 4, 2018, to October 23, 2020, in nine tertiary general hospitals in Central-South China. Epidemiologic and clinical data from patients’ electronic medical records were collected and analyzed. Results One hundred and sixteen patients with C. psittaci pneumonia were included in the study. The mean age was 59.7 years. Fever (96.6%) and cough (65.5%) were the most common clinical symptoms. Most patients presented with an increase in the proportion of neutrophils, neutrophil to lymphocyte ratio, LDH, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and a significant decrease in lymphocytes. The main CT lung findings were consolidation (81%) and pleural effusion (35.3%), and bilateral lung consolidation was mainly found in severe patients. Chlamydia psittaci DNA was detected in BALF (bronchoalveolar lavage fluid) or blood samples by metagenomic next-generation sequencing (mNGS) in all patients. Use of quinolone was associated with shorter length of hospital stay and fever duration after antibiotic use. Multivariate logistic regression analysis indicated that respiratory support was associated with both severe pneumonia and in-hospital death. Conclusions The clinical phenotype of C. psittaci pneumonia is complex and variable. mNGS is helpful in the diagnosis and treatment of C. psittaci pneumonia, and early treatment with quinolone may benefit patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00662-4.

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“…However, in recent years, fulminant severe C. psittaci pneumonia has been described more frequently using metagenomic nextgeneration sequencing (mNGS) in clinical practice (2,3,10), and it is crucial to understand its clinical characteristics and identify its risk factors. There have some case reports or case series reported about clinical manifestations of C. psittaci pneumonia, but the sample sizes are limited (11,12). Meanwhile, to the best of our knowledge, there has been little research focusing on the risk factors of severe C. psittaci pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Severe Chlamydia psittaci pneumonia: clinical characteristics and risk factors

Su¹,

Su²,

Zhou³

et al. 2021

Ann Palliat Med

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Background: Psittacosis ranges from a mild illness to fulminant severe pneumonia with multi-organ failure.It's crucial to understand the clinical characteristics and identify risk factors for a better outcome. Methods:We conducted a retrospective analysis designed to identify risk factors for severe Chlamydia psittaci pneumonia (C. psittaci pneumonia) by comparing the clinical characteristics of patients with severe and less severe forms of the disease. Epidemiological, clinical, laboratory, computed tomography (CT) imaging, and outcome data were collected.Results: We enrolled 27 patients with C. psittaci pneumonia, with a median age of 63 (range, 47-82) years, and 23 of whom (85.2%) had a history of avian exposure. Dyspnea was seen in 15 patients with severe C. psittaci pneumonia (100%), and four in 12 non-severe patients (33.3%) (P<0.01). Compared to nonsevere patients, those with severe C. psittaci pneumonia had significantly higher levels of procalcitonin, urea nitrogen, lactate dehydrogenase, creatine kinase (CK), B natriuretic peptide (BNP), myoglobin, IL-6, and IL-10, as well as lower lymphocyte and CD8+ T cell counts, and P a O 2 /F i O 2 ratio. Among patients with severe infection, CT showed that 46.7% had multi-lobar (more than two lobes) pneumonia, whereas its incidence was 0% in non-severe patients (P=0.01). Multivariate analysis revealed that the independent risk factors associated with severe C.

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Clinical characteristics of Chlamydia psittaci pneumonia

Cited by 21 publications

References 5 publications

Clinical, radiological and pathological characteristics of moderate to fulminant psittacosis pneumonia

Clinical, radiological and pathological characteristics of moderate to fulminant psittacosis pneumonia

Clinical Characteristics of Chlamydia psittaci Pneumonia Infection in Central South China

Severe Chlamydia psittaci pneumonia: clinical characteristics and risk factors

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