Abstract
PurposeChlamydia psittaci infection in humans can lead to serious clinical manifestations, including severe pneumonia, adult respiratory distress syndrome, and, rarely, death. Implementation of metagenomic next-generation sequencing (mNGS) gives a promising new tool for diagnosis. The clinical spectrum of severe psittacosis pneumonia is described to provide physicians with a better understanding and to highlight the rarity and severity of severe psittacosis pneumonia.MethodsNine cases of severe psittacosis pneumonia were diagnosed using mNGS. Retrospective analysis of the data on disease progression, new diagnosis tool, treatments, and outcomes, and the findings were summarised.ResultsFrequent symptoms included chills and remittent fever (100%), cough and hypodynamia (100%), and headache and myalgia (77.8%). All patients were severe psittacosis pneumonia developed respiratory failure, accompanied by sepsis in 6/9 patients. mNGS takes 48–72 h to provide the results, and help to identify diagnosis of psittacosis. Laboratory data showed normal or slightly increased leucocytes, neutrophils, and procalcitonin but high C-reactive protein levels. Computed tomography revealed air-space consolidation and ground-glass opacity, which began in the upper lobe of one lung, and spread to both lungs, along with miliary, nodular, or consolidated shadows. One patient died because of secondary infection with Klebsiella pneumoniae, while the other eight patients experienced complete recoveries.ConclusionsThe use of mNGS can improve accuracy and reduce the delay in diagnosis of psittacosis. Severe psittacosis pneumonia responds well to the timely use of appropriate antibiotics.
Highlights
Chlamydia psittaci infection in humans, known as parrot fever, ornithosis, or psittacosis, usually manifests as pneumonia, which ranges in severity from asymptomatic to fatal [1, 2]
We describe the clinical features of severe psittacosis pneumonia diagnosed by metagenomic next-generation sequencing (mNGS), and demonstrate that mNGS is an effective method for establishing the diagnosis
We reported a retrospective study of the application of mNGS in the diagnosis of C. psittaci infection, manifesting as severe pneumonia, and the clinical features of C. psittaci infection
Summary
Chlamydia psittaci infection in humans, known as parrot fever, ornithosis, or psittacosis, usually manifests as pneumonia, which ranges in severity from asymptomatic to fatal [1, 2]. Chlamydia psittaci is responsible for less than 5% of community-acquired pneumonia [3, 4]. Several outbreaks of C. psittaci infections in humans have occurred in different countries over the past 20 years, with a case fatality rate of less than 1% [5, 6]. Chlamydia psittaci occurs in Psittacinae and pigeons and in poultry. Poultry, including chickens and ducks, are the most important sources of infection in China. One study found that the prevalence of C. psittaci in poultry sold in markets was 13% in chickens, 39% in ducks, and 31% in pigeons [7]
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