1/77. Fulminant psittacosis requiring mechanical ventilation and demonstrating serological cross-reactivity between legionella longbeachae and Chlamydia psittaci. Chlamydia psittaci infection typically causes a mild respiratory illness in humans. Severe respiratory failure requiring mechanical ventilation or intensive care therapy is an uncommon development. The aetiological agents causing severe community acquired pneumonia often remain undetermined. Serological tests may aid in diagnosis. We present two cases of fulminant psittacosis, one demonstrating early cross-reactivity with legionella longbeachae. ( info) |
2/77. Echocardiographic follow-up of Chlamydia psittaci myocarditis. Chlamydia psittaci myocarditis has been infrequently reported. A case of serologically confirmed C psittaci myocarditis with dilated left ventricle and severely impaired left ventricular function is described. Serial echocardiograms demonstrated complete recovery after therapy. An early diagnosis has important prognostic implications. ( info) |
| Experience with two cases of psittacosis is described here in which the number of gammadelta T cell receptor-positive T lymphocytes (gammadelta T cell) in the bronchoalveolar lavage fluid was markedly increased (25.1 and 66.9%) and CD8 T cells were also increased with reversal of the CD4/CD8 ratio. These values improved to the normal range along with recovery of their radiographical findings. The present findings suggest that gammadelta T cells may play an important role in protection from lung injury caused by Chlamydia psittaci infection. ( info) |
4/77. ARDS in fulminant ornithosis and treatment with extracorporeal lung assist. We report a 47-year-old male patient with fulminant ornithosis who developed severe respiratory failure leading to acute respiratory distress syndrome (ARDS) complicated by gastrointestinal, neurological and renal symptoms. ARDS was successfully treated by extracorporeal lung assist. As leukocytosis is typically absent in ornithosis, c-reactive protein, interleukin 6 and procalcitonin were used as infection parameters in order to monitor clinical development. The English-language literature on severe cases of ornithosis requiring respiratory support over the past 30 years is reviewed. ( info) |
5/77. A possible association between Chlamydiae psittacci infection and temporal arteritis. Some arguments are in favor of the role of Chlamydia in the pathogenesis of atherosclerosis and some vasculitis. Illustrating this possible relation, we report the case of a patient developing consecutively a Chlamydia psittacci infection and a temporal arteritis. A 73-year-old woman, with no significant medical history, was hospitalized for constitutional symptoms. Three weeks before, she had described fever and sore throat of two days' duration. Since that time, she had remained exhausted and developed a mild intermittent claudication of the jaws. Clinical examination was poor. A biological inflammatory syndrome was noticed. Chest X-ray revealed bilateral interstitial opacities. The titer of anti-C. psittaci antibodies was significant (positive 1g G at 1/2048). Soon after initiation of doxycycline, a temporal arteritis biopsy was performed, due to the persistence of clinical symptoms and high inflammatory syndrome, conclusive for the diagnosis of temporal arteritis. Corticotherapy was added to antibiotic therapy, resulting in the decrease of inflammatory syndrome and an improvement in the general status of the patient. X-ray opacities decreased in three weeks. Serological control after three months showed a decrease of the titer of anti-C. psittacci antibodies to 1/256, confirming the initial diagnosis of Chlamydia pneumopathy. Our observation could provide one more argument for the role of bacteria-like Chlamydia in the pathogenesis of vascular diseases. Prospective seroepidemiological and molecular biology studies could allow us to clarify the association between chlamydia infections and inflammatory vasculitis-like temporal arteritis. ( info) |
| BACKGROUND: psittacosis is a relatively common cause of community acquired pneumonia in adults in australia. Although the illness is usually mild to moderate in severity, it can, be life threatening. It should be considered as a possible cause of any flu like illness. OBJECTIVE: This article aims to describe the clinical presentation, diagnostic investigation and outpatient management of psittacosis. DISCUSSION: The key to the management of psittacosis is considering the diagnosis. If a history is obtained of contact with birds, a careful search for respiratory symptoms, signs or chest X-ray changes should take place. If the clinical likelihood is high, empirical therapy with doxycycline should be started. Acute and convalescent serology should then be taken to help establish the diagnosis. ( info) |
| Six elderly patients with serological evidence of psittacosis but atypical syndromes are described. These cases illustrate the difficulties in diagnosing this infection in the old. Four patients were febrile and three had lesions visible on X-ray of the chest. Three died, in one acute toxic viral myocarditis seemed the cause. All were treated with tetracycline, which must be given generously. psittacosis infection would probably be more commonly diagnosed in the old if serological examinations were carried out in old people immediately on their administration to hospital because of a severe febrile illness. Serological tests appear clearly to be the most certain means of identifying psittacosis in patients with multiple pathology. ( info) |
8/77. Familial cases of psittacosis: possible person-to-person transmission. A 29-year-old woman with primary myelofibrosis developed severe pneumonia, and 20 days later her 31-year-old sister also contracted pneumonia. The first patient had been in contact with parakeets but the second patient had not been in contact with any birds. psittacosis was diagnosed in both cases by microplate immunofluorescence antibody technique. Person-to-person transmission between the sisters was suspected to have taken place. ( info) |
| This study reports an extraordinarily severe and prolonged course of neuroornithosis with generalized status epilepticus as an initial symptom. Direct invasion of the central nervous system by chlamydophila psittaci was confirmed by the demonstration of specific dna in the patient's cerebrospinal fluid. The patient recovered slowly under administration of doxycycline. ( info) |
10/77. Chlamydia psittaci pneumonia presenting as acute generalised peritonism. A 63 year old man presented with the signs of acute generalised peritonism in the presence of a clear chest radiograph. At laparotomy no abnormal findings were noted. Further inquiries revealed a history of recent acquisition of budgerigars, over the following days the chest radiograph developed patchy opacification. Subsequently IgG immunofluorescence confirmed the diagnosis of Chlamydia psittaci. The presentation of psittacosis with gastrointestinal features is well recognised. This is believed to be the first account in the literature of a human case of Chl psittaci pneumonia presenting with acute generalised peritonism indicating an exploratory laparotomy. It is suggested that Chl psittaci pneumonia should be considered in the differential diagnosis of an acute abdomen in the presence of a history of exposure to psittacine birds. ( info) |