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PubMed1992

A family outbreak of Chlamydia pneumoniae infection.

Chlamydia pneumoniae, a newly described Chlamydia species, has been shown to be a cause of acute respiratory tract infection in both adults and children, but its role in human infection is still under investigation. Here we present a family outbreak of C. pneumoniae infection where three members of a family presented with a 'flu-like illness' and acute upper respiratory tract infection which did not improve despite penicillin or septrin therapy. No history of exposure to birds, pets or animals was obtained. As C. pneumoniae isolation from respiratory secretions is not without difficulty, diagnosis usually relies currently on serum-based tests. In this study C. pneumoniae specific IgM determined by the micro-immunofluorescence test was detected in the three clinical cases. All three cases had an elevated complement-fixing antibody titre to Psittacosis-LGV antigen, which may have suggested psittacosis, if type-specific tests had not been performed. In addition, three other members of the family had C. pneumoniae-specific IgG antibody although specific IgM was absent. These three younger members of the family had been symptomatic in the month preceding symptoms in their older sibling and their parents. All the symptomatic members of the family made a complete recovery on tetracycline therapy.

Adult↗
PubMed2005

Increasing incidence of megabacteriosis in canaries (Serinus canarius domesticus).

A total of 312 post-mortem examinations of 178 canaries (Serinus canarius domesticus), 40 parakeets (Melopsittacus undulatus, Nymphicus hollandicus) and 94 parrots (Amazona aestiva, Psitaccus erithacus) were conducted at the Birds and Rabbits Service of the University of Liège, Belgium. After a detailed gross examination, tissue samples were collected for virological and/or bacteriological and/or parasitological examination to complete the diagnosis. In all cases, a microscopic examination of the proventricular mucus layer was undertaken for the detection of the anamorphic ascomycetous yeast Macrorhabdus ornithogaster, which causes the non-zoonotic but important disease in cage birds known as megabacteriosis. At the time of death, megabacteriosis was diagnosed respectively in 28% of canaries and 22.5% of budgerigars (P value for Fisher's exact test=0.5576), but was not diagnosed in parrots (P value for Fisher's exact test <0.0001). The incidence of megabacteriosis significantly increases along the years (P value for chi2 test <0.0001, Cramer's coefficient=0.3405). The most common gross lesions seen at necropsy of the 59 megabacteriosis cases was proventricular dilatation (86.1%). All the birds diagnosed as typical megabacteriosis cases were free of Salmonella spp. infections and of any parasitic infections. Four megabacteriosis cases (three canaries, one parakeet) were not included in statistical analysis as salmonellosis, pseudotuberculosis, coccidiosis and chlamydophilosis were diagnosed concomitantly in these birds. With the exception of megabacteriosis, the most frequent causes of death were protozoan (coccidiosis, lankesterellosis) infections (18.4%) and salmonellosis (17.1%) in canaries, and psittacosis (31.5%) and viral hepatitis (26.3%) in parakeets. In parrots, the most common causes of death were psittacosis (28.6%) and aspergillosis (28.5%).

Animals↗
PubMed2026

Non-invasive management of severe chlamydia psittaci pneumonia presenting with hypoxemia and diarrhea: a case report.

This case report describes a rare presentation of severe Chlamydia psittaci pneumonia in a 43-year-old female patient with prominent hypoxemia and gastrointestinal symptoms, and evaluates the efficacy of standardized non-invasive integrated management for critically ill patients with this atypical phenotype. The patient was admitted with lumbago, persistent high fever, progressive dyspnea, severe hypoxemia, and intractable non-bloody watery diarrhea. Chest computed tomography (CT) revealed extensive bilateral pulmonary ground-glass opacities and consolidation. Rapid and precise etiological diagnosis was achieved via targeted metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF), which identified high-load Chlamydia psittaci infection, with 227,155 normalized reads and a genomic coverage of 98.6%. Comprehensive non-invasive multidisciplinary management was implemented throughout the disease course, including high-flow nasal cannula (HFNC) oxygen therapy, dual anti-infective therapy with omadacycline combined with levofloxacin, symptomatic supportive care, and standardized stepwise early rehabilitation training. Dynamic monitoring of clinical and laboratory indicators showed a gradual and sustained decline in inflammatory biomarkers (C-reactive protein,procalcitonin, interleukin-6),accompanied by progressive absorption of pulmonary lesions and recovery of respiratory function. The patient avoided invasive mechanical ventilation throughout hospitalization, was successfully weaned from HFNC on day 14 of admission, and achieved completeclinical, laboratory and radiological recovery at the 1-month follow-up. This case conforms to the CARE (CAse REports) reporting guidelines. It highlights that severe psittacosis pneumonia can present with atypical dominant manifestations of combined hypoxemia and severe gastrointestinal diarrhea, which is easily misdiagnosed clinically. Targeted mNGS enables rapid etiological confirmation of atypical severe psittacosis, and individualized non-invasive integrated management can achieve favorable prognosis in eligible critically ill patients, providing a valuable clinical reference for the standardized diagnosis and treatment of similar rare cases.

atypical clinical manifestation↗
PubMed2004

Severe Chlamydophila psittaci pneumonia rapidly diagnosed by detection of antigen in sputum with an immunochromatography assay.

We report a case of severe Chlamydophila (Chlamydia) psittaci pneumonia rapidly diagnosed by detection of antigen in sputum with an immunochromatography assay. The patient was admitted to our hospital because of shock, disturbance of consciousness, accidental hypothermia, and multiple organ dysfunction syndrome, and he recovered after administration of intravenous erythromycin and high-dose methylpredonisolone therapy. Psittacosis was confirmed by detection of 16S rRNA gene of C. psittasi in sputum with multiplex-polymerase chain reaction analysis. Serological responses to C. psittasi, C. trachomatis, and C. pneumoniae were also evaluated, and serological cross-reactivity was observed between each species. We consider that the commercially available immunochromatography assay for Chlamydia species can be helpful for rapid diagnosis of Chlamydia infection of the respiratory tract. Hereafter, further examination will be necessary regarding pretreatment of specimens or detection sensitivity and specificity.

Aged↗
PubMed1985

Chlamydial infections.

Chlamydiae are small bacteria that have a unique life cycle. There are two species, Chlamydia psittaci and C. trachomatis, which cause a wide spectrum of clinical disease, including neonatal conjunctivitis and pneumonia, sexually transmitted disease, psittacosis, and trachoma. The importance of chlamydial disease in public health is being increasingly recognized, and the incidence in developed countries seems to be increasing. An understanding of chlamydial disease, its prevention and treatment, is essential for the infection control practitioner, who can play a significant role in patient education.

Chlamydia↗
PubMed1987

Detection of Chlamydia psittaci from various animal species by reverse passive haemagglutination.

A reverse passive haemagglutination test (RPH) has previously been developed to detect the genus-specific antigen of Chlamydia. Clinical samples were obtained from various sites of different animal species. The RPH test detected chlamydial antigen from clinical cases of conjunctivitis in cats, abortion in sheep and psittacosis in birds. Although not as sensitive as cell culture isolation, this test has the advantages of rapidity and of detecting antigen from dead chlamydiae.

Abortion, Veterinary↗
PubMed1996

Acute transverse myelitis associated with Chlamydia psittaci infection.

We report a case of transverse myelitis presenting with fever and rapidly deteriorating neurological signs associated with Chlamydia psittaci infection. It resolved with no long-standing neurological consequences. Only one previous report has described transverse myelitis in association with psittacosis, and this resulted in permanent neurological sequelae.

Acute Disease↗
PubMed1987

Zoonoses acquired from pet birds.

The diagnosis, treatment, pathology, and epidemiology of psittacosis, the principal zoonotic disease contractible from birds, in human beings and in birds is discussed at length. Salmonellosis, toxoplasmosis, and allergic alveolitis are also considered. Several bacterial, viral, fungal, and parasitic organisms are mentioned as potential zoonoses.

Animals↗
PubMed1997

Detection of Chlamydia psittaci DNA in avian clinical samples by polymerase chain reaction.

A polymerase chain reaction (PCR) assay was developed to detect. Chlamydia psittaci DNA in faeces and tissue samples from avian species. Primers were designed to amplify a 264 bp product derived from part of the 5' non-translated region and part of the coding region of the ompA gene which encodes the major outer membrane protein. Amplified sequences were confirmed by Southern hybridization using an internal probe. The sensitivity of the combined assay was found to be between 60 to 600 fg of chlamydial DNA (approximately 6 to 60 genome copies). The specificity of the assay was confirmed since PCR product was not obtained from samples containing several serotypes of C. trachomatis, strains of C. pneumoniae, the type strain of C. pecorum, nor from samples containing microorganisms commonly found in the avian gut flora. In this study, 404 avian faeces and 141 avian tissue samples received by the Central Veterinary Laboratory over a 6 month period were analysed by PCR, antigen detection ELISA and where possible, cell culture isolation. PCR performed favourably compared with ELISA and cell culture, or with ELISA alone. The PCR assay was especially suited to the detection of C. psittaci DNA in avian faeces samples. The test was also useful when applied to tissue samples from small contact birds associated with a case of human psittacosis where ELISA results were negative and chlamydial isolation was a less favourable method due to the need for rapid diagnosis.

Animals↗
PubMed1984

[Severe Chlamydia psittaci pneumopathy in an adult].

A previously well 56 year-old woman presented with an adult respiratory distress syndrome which worsened under penicillin treatment, responding only to erythromycin and rifampicin, as well as CPAP ventilation. Diagnostic serology was positive to Chlamydia psittaci. Psittacosis is not a frequent cause of primary extensive pneumonia in intensive care units; other diseases should be looked for in the presence of these non-specific clinical and biological pictures (Legionella pneumophila, Mycoplasma pneumoniae, Streptococcus pneumoniae). Pneumocystis should also be looked for in a typical pneumonia; erythromycin is the antibiotic of first choice in the treatment of primary extensive pneumonia.

Critical Care↗
PubMed1983

Resistance of wild birds to infection by Chlamydia psittaci of mammalian origin.

Numerous species of birds are natural hosts of C. psittaci and have been implicated as sources of certain strains that cause disease in other vertebrate species, notably those producing psittacosis or ornithosis in humans [1]. Although direct evidence of their involvement in the transmission of chlamydiae to other mammals, especially domesticated ruminants, has not been reported, a careful examination of this possibility is justified [1]. When inoculated parenterally, polyarthritis-producing chlamydiae of ovine origin affected leg joints of turkeys, and abortion-producing chlamydiae of ovine origin was infectious for pigeons and fatal for sparrows [2]. However, several species of small wild birds (three of which were used in the experiments reported here), when inoculated perorally with C. psittaci of turkey origin, seroconverted (36%) and shed the organism (79%) [3]. Therefore, the present study was undertaken to determine whether strains of C. psittaci from domesticated ruminants would infect, multiply in, or be shed by these wild birds. The results indicate that these species of birds are not natural hosts or biologic vectors of these strains. However, considering the heterogeneity of Chlamydia species, certain birds may harbor strains that are associated with naturally occurring infections in some animals. The results also are additional evidence of the more restricted host range of mammalian Chlamydia species as compared to that of avian isolates.

Animals↗
PubMed1989

[The clinical effectiveness of OFLX in the treatment of chlamydial pneumonia].

We treated three patients of chlamydial pneumonia with OFLX, two patients were diagnosed as psittacosis and one as pneumonia associated with TWAR strain by serologic test. Three hundred mg of OFLX was orally administered three times per day and the duration of treatment was from seven to fourteen days, and we compared the clinical effectiveness of OFLX in three cases (mild: 1, moderate: 2) with that of MINO in eleven cases (mild: 3, moderate: 8), who were administered two hundred mg of MINO two times per day orally or intravenously. We isolated C. psittaci from three pet birds including case 2 and the in vitro activity of OFLX and MINO against three strains of C. psittaci was determined. Clinical effectiveness were observed and obtained results were as follows. 1) In OFLX group, three patients judged as "Good", and in MINO, one patient as "Excellent", ten as "Good". 2) The duration of pneumonic shadow was 9.33 +/- 3.21 in OFLX group, 10.3 +/- 3.50 in MINO group, and there was no significant difference between both groups. 3) The in vitro activity of OFLX and MINO against 3 strains was 0.78-1.56 micrograms/ml and 0.025 microgram/ml, respectively. From these results, it was concluded that OFLX was considered to be a useful antichlamydial agent in the treatment of mild or moderate cases of chlamydial pneumonia.

Adolescent↗
PubMed1996

[A family outbreak of Chlamydia psittaci infection].

A family outbreak (3 cases) of Chlamydia psittaci infection was reported. The first case, a 56-year-old man was admitted with fever and general fatigue. Chest X-ray film revealed a consolidation in the right lower lung. One month before admission he had purchased 2 parakeets (chick) and one parakeet died. On learning of his history of contact with the chick, psittacosis was suspected. After administration of fixation (CF) antibody titer against chlamydia rose to 1:128 and IgA titer against Chlamydia psittaci by microimmunofluorescence antibody technique (MAF) rose to 1:128 in 21 days after admission. The second case, the wife of the first, a 53-year-old woman had a fever and a cough about two weeks before the admission of the first case. At the time of her husband was admitted, she attended the outpatient department. The chest CT X-ray film showed a ground glass appearance in both lower lung fields. The third case, the daughter of the first, didn't have any signs. Chest X-ray film was normal. But IgM titer against Chlamydia psittaci by MAF rose to 1:16 and IgA titer against Chlamydia psittaci by MAF rose to 1:128. This case was considered as inapparent infection.

Adult↗
PubMed1972

Indirect hemagglutination test for chlamydial antibodies.

An indirect hemagglutination (IHA) test is described for chlamydial antibodies in psittacosis diagnostic sera; for this test tanned sheep erythrocytes sensitized with a deoxycholate extract of Chlamydia psittaci grown in Vero cell monolayers were used. Adaptation of the IHA test to the Microtiter system decreased sensitivity; nevertheless, the Microtiter-IHA test was more sensitive than the complement fixation test. Lymphogranuloma venereum antibodies also were detected by using antigen extracted from C. psittaci.

Animals↗
PubMed1975

Fluorescent antibody studies in chlamydial infections.

Irradiated McCoy cells infected with genital strains of Chlamydia trachomatis were grown in wells on slides coated with polytetrafluoroethylene. The inclusions produced in this system formed the antigen in an indirect immunofluorescence test, which detected group-specific chlamydial antibodies in sera from patients attending veneral disease clinics. Chlamydial antibodies were found more frequently and in higher titer in sera from women attending veneral disease clinics then in sera from a less promiscuous population attending a Family Planning Association clinic. Paired sera from 13 patients with nongonococcal urethritis from whom chylamydiae had been isolated were tested against the homologous isolates; seroconversion was demonstrated in only one instance, and antibody was present in the first serum specimens of all the other patients. Chlamydia-specific immunoglobulin M was found in four of eight patients with psittacosis and in a proportion of sera from patients attending veneral disease and Family Planning Association clinics. The antigen for this immunofluorescence test can easily be prepared in laboratories with cell culture facilities for the isolation of C. trachomatis, and the test should be useful for laboratories which cannot undertake the micro-immunofluorescence test.

Antibodies, Bacterial↗
PubMed1979

Reticulate bodies as single antigen in Chlamydia trachomatis serology with microimmunofluorescence.

Formalin-fixed, purified reticulate bodies (RB) of Chlamydia trachomatis immunotype C/TW-3/OT were used as a serological test antigen in the microimmunofluorescence test. The sensitivity and specificity of the RB antigen were compared to elementary bodies (EB) used as antigens in the detection of C. trachomatis antibodies in human sera by microimmunofluorescence. RB reacted with all known C. trachomatis immunotypes with the same sensitivity as the homotypic EB. In routine serology with sera and endocervical secretions, the RB antigen had a sensitivity similar to that of the EB in detecting serum antibodies, endocervical secretion antibodies, and antibodies of immunoglobulin M and G classes. No false-positive reactions were detected with control sera. All positive reactions showed type-specific antibodies against an EB immunotype. RB seemed to demonstrate chlamydial group reactivity; sera from 10 psittacosis patients diagnosed clinically and serologically by complement fixation showed five positive, three equivocal, and two negative reactions. By immunofluorescence, RB appeared as distinct rings demonstrating uniform peripheral surface fluorescence at their rims. The EB appeared as pinpoint-sized dots. C/TW-3/OT RB used as a single test anitgen should provide a simple and sensitive serological assay for the detection of C. trachomatis antibody.

Antibodies, Bacterial↗
PubMed1977

Enzyme-linked immunosorbent assay for chlamydial antibodies.

An enzyme-linked immunosorbent assay (ELISA) detected chlamydial antibodies in human sera. The assay antigen produced in cell cultures infected with Chlamydia psittaci was Formalin-fixed to microplates. Single convalescent-phase sera positive for chlamydial antibodies by a complement-fixation test were positive at even higher dilutions by ELISA. Paired sera with diagnostic rises in complement-fixing antibody showed seroconversion by ELISA also. Control sera from persons with no history of chlamydial infection were negative by both tests. Sera from patients with psittacosis or lymphogranuloma venereum were ELISA positive, indicating that the assay with the antigen used in this study is genus specific rather than species specific.

Antibodies, Bacterial↗
PubMed2003

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.

Acute Disease↗