Diagnosis and treatment of Chlamydia psittaci infection, one article!

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Psittacosis is a zoonotic infectious disease, mainly caused by the intracellular parasitic gram-negative bacteria Chlamydia psittaci
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Birds, poultry and wild animals can be carried and infected.
Humans can be infected by humans through respiratory tract inhalation or close contact.
Human-to-human transmission is also possible, but it is relatively rare
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Regarding the clinical manifestations and treatment of psittacosis, let's take a look! 1 Epidemiology Chlamydia psittaci can affect people of any age and gender, but the incidence peaks in middle age, ranging from 35 to 55 years old
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The pathogen has been found in many countries and regions around the world, and with the migration of animals and the increasing number of pet birds, the infection of Chlamydia psittaci is also showing an increasing trend year by year
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2 Clinical manifestations The symptoms of human infection with Chlamydia psittaci are mainly respiratory diseases, but the clinical manifestations may be different
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Chlamydia psittaci is very pathogenic.
Infected people often have flu-like symptoms such as chills, sore throat and headache.
In severe cases, it can lead to various complications such as pneumonia, endocarditis and encephalitis, and endanger Life
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Studies have shown that the average incubation period of Chlamydia psittaci infection from asymptomatic to fulminant invasive disease is 5-14 days
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Other symptoms include changes in mental status, neck stiffness, photophobia, hepatosplenomegaly, and pharyngitis
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Chlamydia psittaci can affect many systems and organs throughout the body.
The clinical manifestations are as follows: When the central nervous system is affected, it can be manifested as meningitis, cerebellar ataxia, cranial nerve palsy, rhabdomyositis, Guillain-Barré syndrome, and epilepsy
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Respiratory manifestations include pneumonia, acute respiratory distress syndrome, respiratory failure, and septic shock
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When the heart is affected, it may present myocarditis, pericarditis, endocarditis, and aortitis
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Kidney and digestive system manifestations include acute interstitial nephritis, acute renal failure, glomerulonephritis, hepatitis, pancreatitis, and acute abdomen
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Hematological manifestations include diffuse intravascular coagulation (DIC), splenomegaly, and hematopoietic syndrome
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Rheumatism manifestations include reactive arthritis and polyarteritis
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3 Diagnosis The laboratory test results of psittaci are non-specific and can show abnormal liver function, anemia, and leukopenia
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Most chest X-rays of Chlamydia psittaci pneumonia mainly show varying degrees of pulmonary infiltration, which is also not specific
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Although Chlamydia psittaci infection is closely related to bird contact, it is not a necessary condition for diagnosis, especially in areas where a large number of wild birds live
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The diagnosis of most patients is based on medical history, occupation, hobbies, travel history, and a high degree of suspicion
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The diagnostic guidelines for psittacosis issued by the Centers for Disease Control and Prevention (CDC) point out that under appropriate clinical conditions, it can be diagnosed if one of the following criteria is met: ①Isolate pathogenic bacteria from respiratory secretions ②Pass complement fixation test (CFT) Or the antibody titer between the serum samples collected 2 weeks apart from the micro immunofluorescence (MIF) detection increased by 4 times or more ③ The single IgM antibody titer for MIF detection is 1:16 or higher.
It is worth noting that Chlamydia psittaci is common The detection rate of bacterial culture is low; cell culture is time-consuming and requires high levels of laboratory biosafety and cannot be carried out routinely; serological tests have low early diagnostic value and are suitable for retrospective diagnosis
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4 Treatment and prognosis The treatment of Chlamydia psittaci infection is mainly based on intracellular activity, pharmacokinetics and evidence from clinical trials.
Tetracycline antibiotics are recommended, and doxycycline is recommended for patients without contraindications
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The case report showed that the fever and clinical symptoms of most infected patients improved within 48 hours of treatment
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For patients who cannot use tetracyclines, macrolide antibiotics, such as azithromycin and erythromycin, can be selected
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The third-line antibiotics for treating Chlamydia psittaci infection include quinolones, which are less effective than tetracycline and macrolide drugs
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The prognosis of psittacosis depends mainly on the severity of the patient, comorbidities, and the duration of treatment and supportive care
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Despite antibiotic treatment, it is estimated that the mortality rate is 1%
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Psittacosis.
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Treatment and care of critically ill patients with Chlamydia psittaci pneumonia.
Chinese Journal of Clinical Infectious Diseases.
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