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Abortion due to infection with Chlamydia psittaci in a sheep farmer's wife.

A farmer's wife who had helped with lambing aborted spontaneously in March after a short febrile illness in the 28th week of her pregnancy. She developed disseminated intravascular coagulation post partum with acute renal failure and pulmonary oedema. Recovery was complete after two weeks of hospital care. A strain of Chlamydia psittaci, probably of ovine origin, was isolated from the placenta and fetus. The patient's serum showed rising titres of antibody against chlamydia group antigen; the placental and fetal isolates; and a known ovine abortion, but not a known avian, strain of C psittaci. IgG against both ovine abortion and enteric strains of C psittaci was detected, but IgM against only an abortion strain was detected. Histological examination showed pronounced intervillus placentitis with chlamydial inclusions in the trophoblast but no evidence of fetal infection or amnionitis. Laboratory evidence of chlamydial infection was found in an aborting ewe on the farm in January and in remaining sheep and lambs in July. Doctors should recognise the possible risk to pregnant women in rural areas where chlamydial infections in farm animals are widespread.

Abortion, Spontaneous↗

Successful treatment by doxycycline of endocarditis caused by ornithosis.

The case of a 59 year old man with ornithosis endocarditis and a history of contact with pheasants is reported. Treatment with oxytetracycline was not tolerated and so doxycycline was substituted. Over the two year follow up the patient's clinical condition and serial echocardiographic appearances improved and Chlamydia psittaci complement fixation titres returned to normal. Valve replacement was not required.

Doxycycline↗

Sensitivity of immunoperoxidase and immunofluorescence staining for detecting chlamydia in conjunctival scrapings and in cell culture.

The sensitivities of Giemsa, immunofluorescence, and immunoperoxidase staining for the detection of Chlamydia psittaci inclusions in conjunctival scrapings and in irradiated McCoy cell monolayers were compared. Conjunctival specimens were obtained from a cat colony in which a trachoma-like disease, feline chlamydial keratoconjunctivitis, was endemic. The two immunochemical techniques were found to be of equal sensitivity and 50% to 100% more sensitive than Giemsa stain. Permanent preparations of immunoperoxidase stained material can be made and can be read using a simple light microscope. These features make the technique more useful than immunofluorescence staining, which gives temporary preparations that must be examined with a specialised fluorescence microscope.

Animals↗

Acute placentitis and spontaneous abortion caused by chlamydia psittaci of sheep origin: a histological and ultrastructural study.

A sheep farmer's wife who had been assisting with lambing developed an influenza like illness in the 28th week of pregnancy. After five days of malaise she spontaneously delivered a stillborn infant; she became acutely ill during the immediate postpartum period with septicaemic shock, acute renal failure, and disseminated intravascular coagulation. The diagnosis was made by isolation and identification of Chlamydia psittaci from the placenta, fetal heart blood, and fetal lung, together with maternal serological evidence. The prominent histological and ultrastructural appearances of the chlamydial placentitis are described.

Abortion, Spontaneous↗

Serum angiotensin converting enzyme in pneumonias.

Serum concentrations of angiotensin converting enzyme (ACE) were studied in pneumonias caused by different pathogens and in cases in which the aetiology could not be defined. In all aetiological groups, except in viral pneumonia, there was a significant increase in ACE during recovery (p less than 0.001). In several patients the lowest values during the acute phase of disease and the highest values during recovery were outside the reference limits. In cases with known aetiology the highest ACE values and the difference between the lowest and the highest values correlated positively with C-reactive protein concentrations at admission (p less than 0.001). The pathophysiology behind the fluctuations of the ACE concentrations is unknown.

Acute Disease↗

Detection of Chlamydia pneumoniae and Chlamydia psittaci in sputum samples by PCR.

AIMS: To use the polymerase chain reaction (PCR) to detect Chlamydia pneumoniae and Chlamydia psittaci in sputum samples. METHODS: A nested PCR was developed, the first stage of which amplified DNA from both C pneumoniae and C psittaci while the second stage targeted specifically at C pneumoniae, allowing the two species to be differentiated. The primers were designed not to amplify sequences from C trachomatis. A panel of 26 sputum samples from patients with community acquired pneumonia evaluated previously by enzyme linked immunosorbent assay (ELISA), direct immunofluorescence (DIF), and culture was tested blind by PCR. Most of these specimens also had accompanying serial serum samples which were tested for species specific antibodies using microimmunofluorescence (micro-IF). RESULTS: PCR detected C pneumoniae DNA in 10 of the 26 samples and C psittaci DNA in four. There was good concordance between ELISA, DIF, micro-IF and PCR in the C pneumoniae group. Two of the C psittaci identified by PCR were labelled C pneumoniae by DIF but the PCR results were supported by serology or a history of bird contact. Of the PCR negative group: six were true negative results; two contained C trachomatis. There were four discrepant results. CONCLUSIONS: The data suggest that PCR is effective in the detection of C pneumoniae. The sensitivity for C psittaci is inevitably lower due to the strategy taken but specificity seemed to be good.

Bacterial Outer Membrane Proteins↗