Clinical and pathological characteristics of <i>Chlamydia psittaci</i> pneumonia_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

Munaiwaier Sabier ¹ , CHEN Jingsi ¹ , Aboduwaili Aierken ² , LIU Wenjuan ¹ , YIN Honglin ³ , SU Xin ⁴ , Meiriban Waili ⁵ , YE Sheng ¹ ,  WANG Cheng ¹

1. Department of Respiratory and Critical Care Medicine Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu 210019, P. R. China;
2. Department of Pancreatic Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu 210019, P. R. China;
3. Department of Pathology, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu 210019, P. R. China;
4. Department of Respiratory Medicine center, The Nanjing PLA Eastern Theater Command General Hospital, Nanjing, Jiangsu 210002, P. R. China;
5. Department of Heart Failure, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, P. R. China;

Corresponding author：

WANG Cheng, Email: drcw@163.com

Keywords：

Chlamydia psittaci pneumonia; metagenomics with second-generation sequencing technology; bronchoalveolar lavage fluid; deoxytetracycline

DOI：

10.7507/1671-6205.202303010

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Objective To analyse the clinical and pathological characteristics of Chlamydia psittaci pneumonia, and increase the comprehensive understanding of the Chlamydia psittaci pneumonia. Methods Five patients diagnosed with Chlamydia psittaci pneumonia were selected in this hospital from November 2021 to November 2022, and their clinical and pathological characteristics were analysed. Results Out of these five patients, 2 patients were male and 3 were female, with a mean age (65±9) years and length of hospital stay (11 - 13) d. The first symptom of all five patients was fever; 3 patients were complicated with hypoxemia; there were several accompanying symptoms, including chilly, shiver, fatigue, headache, cough, muscle soreness, hearing loss and so on. In the laboratory indicators, white blood cell count was not significantly abnormal, the C-reactive protein and procalcitonin were high. In the chest CT, the diseased regions were mostly located in unilateral lesions, 3 cases were on the right side; the forms included pulmonary consolidation, lung glass opacity, pleural effusion, pleural thickening, etc.; the mNGS results of bronchoalveolar lavage fluid showed the Chlamydia psittaci; the pathology of lung biopsy showed significant proliferation of fibers in the interstitial lung and partly fibrosis, with histiocytic reaction and minimal lymphocyte infiltration. Conclusion Clearly diagnosing patients with pneumonia which are suspected being infected Chlamydia psittaci as soon as earlier can prompt anti-infection treatment, and avoid further damage to the lung interstitium, eventually decrease the deterioration of lung function and progression to severe pneumonia.

Citation： Munaiwaier Sabier, CHEN Jingsi, Aboduwaili Aierken, LIU Wenjuan, YIN Honglin, SU Xin, Meiriban Waili, YE Sheng, WANG Cheng. Clinical and pathological characteristics of Chlamydia psittaci pneumonia. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(12): 863-867. doi: 10.7507/1671-6205.202303010 Copy

1.	Balsamo Gary, 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.
2.	Gaede W, Reckling KF, Dresenkamp B, et al. Chlamydophila psittaci infections in humans during an outbreak of psittacosis from poultry in Germany. Zoonoses Public Health, 2008, 55(4): 184-188.
3.	金文芳, 姚羽, 吕艳玲, 等. 8例鹦鹉热衣原体肺炎患者的临床特征分析及其诊治. 中国感染控制杂志, 2022, 21(2): 165-170.
4.	Chen M, Zhang M, Shi M, et al. Diagnosis and analysis of clinical characteristics of Chlamydia psittaci pneumonia. Vector Borne Zoonotic Dis, 2022, 22(10): 499-504.
5.	刘纯方, 钟屹, 陈家骏, 等. 鹦鹉热衣原体肺炎的临床和CT影像特征. 中华放射学杂志, 2023, 57(3): 315-318.
6.	Cao B, Huang Y, She DY, et al. Diagnosis and treatment of community-acquired pneumonia in adults: 2016 clinical practice guidelines by the Chinese Thoracic Society, Chinese Medical Association. Clin Respir J, 2018, 12(4): 1320-1360.
7.	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.
8.	郭锋, 陈素婷, 董利民, 等. 鹦鹉热衣原体肺炎临床特点及诊治分析. 中国感染控制杂志, 2022, 21(7): 675-680.
9.	Filcek K, Vielfort K, Muraleedharan S, et al. Insertional mutagenesis in the zoonotic pathogen Chlamydia caviae. PLoS One, 2019, 14(11): e0224324.
10.	De Gier B, Hogerwerf L, Dijkstra F, et al. Disease burden of psittacosis in the Netherlands. Epidemiol Infect, 2018, 146(3): 303-305.
11.	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.
12.	许容容, 张蔷, 韩淑华, 等. 43例鹦鹉热衣原体肺炎临床特征. 中国感染控制杂志, 2023, 22(6): 688-694.
13.	Heddema ER, van Hannen EJ, Duim B, et al. An outbreak of psittacosis due to Chlamydophila psittaci genotype A in a veterinary teaching hospital. J Med Microbiol, 2006, 55(11): 1571-1575.
14.	Hogerwerf L, Roof I, De Jong M, et al. Animal sources for zoonotic transmission of psittacosis: a systematic review. BMC Infect Dis, 2020, 20(1): 192-192.
15.	Knittler MR, Sachse K. Chlamydia psittaci: update on an underestimated zoonotic agent. Pathog Dis, 2015, 73(1): 1-15.
16.	Chen XC, Cao K, Wei Y, et al. Metagenomic next-generation sequencing in the diagnosis of severe pneumonias caused by Chlamydia psittaci. Infection, 2020, 48(4): 535-542.
17.	刘斌, 谢波, 黄彭, 等. 鹦鹉热衣原体肺炎患者临床特点分析. 中国感染控制杂志, 2022, 21(2): 159-164.
18.	李田田, 朱淼, 左华芹, 等. 重症鹦鹉热衣原体肺炎的早期影像学特征分析. 临床放射学杂志, 2023, 42(8): 1238-1242.
19.	Li XY, Xiao T, Hu PZ, et al. Clinical, radiological and pathological characteristics of moderate to fulminant psittacosis pneumonia. PLoS One, 2022, 17(7): e0270896.
20.	Atkinson TP, Balish MF, Waites KB. Epidemiology, clinical manifestations, pathogenesis and laboratory detection of Mycoplasma pneumoniae infections. FEMS Microbiol Rev, 2008, 32(6): 956-973.
21.	Su SS, Su XQ, Zhou LP, et al. Severe Chlamydia psittaci pneumonia: clinical characteristics and risk factors. Ann Palliat Med, 2021, 10(7): 8051-8060.

1. Balsamo Gary, 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.
2. Gaede W, Reckling KF, Dresenkamp B, et al. Chlamydophila psittaci infections in humans during an outbreak of psittacosis from poultry in Germany. Zoonoses Public Health, 2008, 55(4): 184-188.
3. 金文芳, 姚羽, 吕艳玲, 等. 8例鹦鹉热衣原体肺炎患者的临床特征分析及其诊治. 中国感染控制杂志, 2022, 21(2): 165-170.
4. Chen M, Zhang M, Shi M, et al. Diagnosis and analysis of clinical characteristics of Chlamydia psittaci pneumonia. Vector Borne Zoonotic Dis, 2022, 22(10): 499-504.
5. 刘纯方, 钟屹, 陈家骏, 等. 鹦鹉热衣原体肺炎的临床和CT影像特征. 中华放射学杂志, 2023, 57(3): 315-318.
6. Cao B, Huang Y, She DY, et al. Diagnosis and treatment of community-acquired pneumonia in adults: 2016 clinical practice guidelines by the Chinese Thoracic Society, Chinese Medical Association. Clin Respir J, 2018, 12(4): 1320-1360.
7. 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.
8. 郭锋, 陈素婷, 董利民, 等. 鹦鹉热衣原体肺炎临床特点及诊治分析. 中国感染控制杂志, 2022, 21(7): 675-680.
9. Filcek K, Vielfort K, Muraleedharan S, et al. Insertional mutagenesis in the zoonotic pathogen Chlamydia caviae. PLoS One, 2019, 14(11): e0224324.
10. De Gier B, Hogerwerf L, Dijkstra F, et al. Disease burden of psittacosis in the Netherlands. Epidemiol Infect, 2018, 146(3): 303-305.
11. 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.
12. 许容容, 张蔷, 韩淑华, 等. 43例鹦鹉热衣原体肺炎临床特征. 中国感染控制杂志, 2023, 22(6): 688-694.
13. Heddema ER, van Hannen EJ, Duim B, et al. An outbreak of psittacosis due to Chlamydophila psittaci genotype A in a veterinary teaching hospital. J Med Microbiol, 2006, 55(11): 1571-1575.
14. Hogerwerf L, Roof I, De Jong M, et al. Animal sources for zoonotic transmission of psittacosis: a systematic review. BMC Infect Dis, 2020, 20(1): 192-192.
15. Knittler MR, Sachse K. Chlamydia psittaci: update on an underestimated zoonotic agent. Pathog Dis, 2015, 73(1): 1-15.
16. Chen XC, Cao K, Wei Y, et al. Metagenomic next-generation sequencing in the diagnosis of severe pneumonias caused by Chlamydia psittaci. Infection, 2020, 48(4): 535-542.
17. 刘斌, 谢波, 黄彭, 等. 鹦鹉热衣原体肺炎患者临床特点分析. 中国感染控制杂志, 2022, 21(2): 159-164.
18. 李田田, 朱淼, 左华芹, 等. 重症鹦鹉热衣原体肺炎的早期影像学特征分析. 临床放射学杂志, 2023, 42(8): 1238-1242.
19. Li XY, Xiao T, Hu PZ, et al. Clinical, radiological and pathological characteristics of moderate to fulminant psittacosis pneumonia. PLoS One, 2022, 17(7): e0270896.
20. Atkinson TP, Balish MF, Waites KB. Epidemiology, clinical manifestations, pathogenesis and laboratory detection of Mycoplasma pneumoniae infections. FEMS Microbiol Rev, 2008, 32(6): 956-973.
21. Su SS, Su XQ, Zhou LP, et al. Severe Chlamydia psittaci pneumonia: clinical characteristics and risk factors. Ann Palliat Med, 2021, 10(7): 8051-8060.

Chinese Journal of Respiratory and Critical Care Medicine

Clinical and pathological characteristics of Chlamydia psittaci pneumonia

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