Application of metagenomic next-generation sequencing in diagnosis of Psittacosis: a report of eight cases_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WANG Yanhong ¹ ,  QIU Yuying ¹ , TANG Jian ³ , ZHU Zhanghua ³ , LIU Ning ³ , YU Zhuxi ³ , LI Yan ² , TONG Jingzhi ²

1. Department of Respiratory and Critical Care Medicine, Gulou Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu 210008, P. R. China;
2. Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, Nanjing, Jiangsu 210008, P. R. China;
3. Department of Critical Care Medicine, Nanjing Drum Tower Hospital, Nanjing, Jiangsu 210008, P. R. China;

Corresponding author：

QIU Yuying, Email: qiuyuying1402@sina.com

Keywords：

Chlamydia psittaci; Psittacosis; Pneumonia; Bronchoalveolar lavage fluid; Metagenomics next-generation sequencing

DOI：

10.7507/1671-6205.202008070

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To improve the understanding of psittacosis, the clinical data of 8 cases are reviewed. The application of pathogen metagenomics next-generation sequencing (mNGS) in the diagnosis of nocardiosis is also investigated.Methods The clinical data of eight patients with psittacosis diagnosed by mNGS in Nanjing Drum Tower Hospital from January 2018 to May 2020 were reviewed. The clinical characteristics, laboratory examination characteristics and imaging changes were analyzed, and the treatment outcome was followed-up.Results Among the eight cases, there were six males and two females, aged 43～83 years old, with an average age of 64±12 years old. Six of them had a clear history of poultry exposure. The major clinical manifestations were fever, cough, dyspnea, etc. Chest high-resolution computed tomography (HRCT) may have solid shadow, ground glass like shadow. Chlamydia psittaci was detected by mNGS in eight patients’ bronchoalveolar lavage fluid. Minocycline or moxifloxacin were administrated, six patients were discharged after their condition improved, and two patients died.Conclusions The incidence of psittacosis is low, and its clinical manifestations lack specificity. In the course of the disease, there may be different degrees of fever, cough, sputum, dyspnea and other symptoms. The lungs can be heard with wet rales, chest HRCT can be seen ground glass shadow, consolidation shadow, accompanied by air bronchogram. Chlamydia psittaci can be detected in alveolar lavage fluid by mNGS. The patients need to be treated for a long time, lasting at least 10 to 14 days. Tetracycline drugs should be the first choice, and can be combined with other antibiotics with activity against gram-positive and gram-negative bacteria in critical patients.

Citation： WANG Yanhong, QIU Yuying, TANG Jian, ZHU Zhanghua, LIU Ning, YU Zhuxi, LI Yan, TONG Jingzhi. Application of metagenomic next-generation sequencing in diagnosis of Psittacosis: a report of eight cases. Chinese Journal of Respiratory and Critical Care Medicine, 2021, 20(7): 472-478. doi: 10.7507/1671-6205.202008070 Copy

1.	Hogerwerf L, DE Gier B, Baan B, et al. Chlamydia psittaci (psittacosis) as a cause of community-acquired pneumonia: a systematic review and meta-analysis. Epidemiol. Infect, 2017, 145: 3096-3105.
2.	Zhang H, Zhan DT, Chen DD, et al. Next-generation sequencing diagnosis of severe pneumonia from fulminant psittacosis with multiple organ failure: a case report and literature review. Ann Transl Med, 2020, 8: 401.
3.	Nieuwenhuizen Annelies A, Dijkstra Frederika, Notermans Daan W, et al. Laboratory methods for case finding in human psittacosis outbreaks: a systematic review. BMC Infect Dis, 2018, 18: 442.
4.	Harris RL, Williams TW, "Contribution to the Question of Pneumotyphus": a discussion of the original article by J. Ritter in 1880. Rev Infect Dis, 1985, 7: 119-122.
5.	Hogerwerf L, Roof I, de Jong MJK, et al. Animal sources for zoonotic transmission of psittacosis: a systematic review. BMC Infect Dis, 2020, 20(1): 192.
6.	Rybarczyk J, Versteele C, Lernout T, et al. Human psittacosis: a review with emphasis on surveillance in Belgium. Acta Clin Belg, 2020, 75(1): 42-48.
7.	Balsamo G, Maxted AM, Midla JW, et al. Compendium of measures to control chlamydia psittaci infection among humans (Psittacosis) and pet birds (Avian Chlamydiosis), 2017. J Avian Med Surg, 2017, 31(3): 262-282.
8.	Radomski N, Einenkel R, Müller A, et al. Chlamydia-host cell interaction not only from a bird's eye view: some lessons from Chlamydia psittaci. FEBS Lett, 2016, 590(21): 3920-3940.
9.	Vande Weygaerde Y, Versteele C, Thijs E, et al. An unusual presentation of a case of human psittacosis. Respir Med Case Rep, 2018, 23: 138-142.
10.	陈涔, 李园园, 潘频华, 等. 二代测序技术在重症社区获得性肺炎诊断中的意义. 中国感染控制杂志, 2020, 19(4): 335-340.
11.	Basarab M, Macrae MB, Curtis CM. Atypical pneumonia. Curr Opin Pulm Med, 2014, 20(3): 247-251.
12.	Jafet A. Psittacosis Pneumonia. Treasure Island (FL): StatPearls Publishing, 2020.
13.	Li M, Zhang XM, Huang K, et al. Presence of Chlamydia trachomatis and Mycoplasma spp. , but not Neisseria gonorrhoeae and Treponema pallidum, in women undergoing an infertility evaluation: high prevalence of tetracycline resistance gene tet(M). AMB Express, 2017, 7(1): 206.
14.	Wichert A, Lukasewitz P, Häuser MH, et al. ARDS in fulminant ornithosis and treatment with extracorporeal lung assist. Int J Artif Organs, 2000, 23: 371-374.

1. Hogerwerf L, DE Gier B, Baan B, et al. Chlamydia psittaci (psittacosis) as a cause of community-acquired pneumonia: a systematic review and meta-analysis. Epidemiol. Infect, 2017, 145: 3096-3105.
2. Zhang H, Zhan DT, Chen DD, et al. Next-generation sequencing diagnosis of severe pneumonia from fulminant psittacosis with multiple organ failure: a case report and literature review. Ann Transl Med, 2020, 8: 401.
3. Nieuwenhuizen Annelies A, Dijkstra Frederika, Notermans Daan W, et al. Laboratory methods for case finding in human psittacosis outbreaks: a systematic review. BMC Infect Dis, 2018, 18: 442.
4. Harris RL, Williams TW, "Contribution to the Question of Pneumotyphus": a discussion of the original article by J. Ritter in 1880. Rev Infect Dis, 1985, 7: 119-122.
5. Hogerwerf L, Roof I, de Jong MJK, et al. Animal sources for zoonotic transmission of psittacosis: a systematic review. BMC Infect Dis, 2020, 20(1): 192.
6. Rybarczyk J, Versteele C, Lernout T, et al. Human psittacosis: a review with emphasis on surveillance in Belgium. Acta Clin Belg, 2020, 75(1): 42-48.
7. Balsamo G, Maxted AM, Midla JW, et al. Compendium of measures to control chlamydia psittaci infection among humans (Psittacosis) and pet birds (Avian Chlamydiosis), 2017. J Avian Med Surg, 2017, 31(3): 262-282.
8. Radomski N, Einenkel R, Müller A, et al. Chlamydia-host cell interaction not only from a bird's eye view: some lessons from Chlamydia psittaci. FEBS Lett, 2016, 590(21): 3920-3940.
9. Vande Weygaerde Y, Versteele C, Thijs E, et al. An unusual presentation of a case of human psittacosis. Respir Med Case Rep, 2018, 23: 138-142.
10. 陈涔, 李园园, 潘频华, 等. 二代测序技术在重症社区获得性肺炎诊断中的意义. 中国感染控制杂志, 2020, 19(4): 335-340.
11. Basarab M, Macrae MB, Curtis CM. Atypical pneumonia. Curr Opin Pulm Med, 2014, 20(3): 247-251.
12. Jafet A. Psittacosis Pneumonia. Treasure Island (FL): StatPearls Publishing, 2020.
13. Li M, Zhang XM, Huang K, et al. Presence of Chlamydia trachomatis and Mycoplasma spp. , but not Neisseria gonorrhoeae and Treponema pallidum, in women undergoing an infertility evaluation: high prevalence of tetracycline resistance gene tet(M). AMB Express, 2017, 7(1): 206.
14. Wichert A, Lukasewitz P, Häuser MH, et al. ARDS in fulminant ornithosis and treatment with extracorporeal lung assist. Int J Artif Organs, 2000, 23: 371-374.

Chinese Journal of Respiratory and Critical Care Medicine

Application of metagenomic next-generation sequencing in diagnosis of Psittacosis: a report of eight cases

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content