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Italian Journal of Pediatrics Aug 2023This case of psittacosis in children, is the first described in literature, in Italy. This respiratory infection can be transmitted to humans from the inhalation of...
BACKGROUND
This case of psittacosis in children, is the first described in literature, in Italy. This respiratory infection can be transmitted to humans from the inhalation of respiratory secretions, feces and plumage aerosol of infected birds (and other animals). Usually it can have an asymptomatic or paucisymptomatic course, and the onset is often flu-like, but in this case the child risked his life for a severe respiratory failure. This report is unique because in children psittacosis is rare, and always misdiagnosed, or could cause a delayed diagnosis because of lack of awareness among the paediatricians and physicians. Furthermore, psittacosis enters a differential diagnosis with SARS-COV2 infection because both diseases may determine dyspnea and atypical pneumonia, up to acute respiratory failure.
CASE PRESENTATION
This clinical case talks about a three-and-a-half-year-old male child affected by psittacosis (or ornithosis), with severe dyspnea and systemic symptoms who required oro-tracheal intubation for acute respiratory failure. The child had slept in a room at home, with some recently bought parrots affected by psittacosis. Initially the child was treated with empiric antibiotic therapy (i.v.ceftriaxone and teicoplanin), but after having isolated the DNA of the germ "Chlamydia psittaci" in both serological and through bronchoalveolar lavage (BAL), he was treated with targeted antibiotic therapy: tetracyclines (doxicillin).
CONCLUSIONS
Psittacosis is an extremely contagious disease, caused by an intracellular germ, called "Chlamydia psittaci", a Gram-negative bacterium, transmitted to humans in particular by infected birds, responsible for atypical pneumonia, with acute and chronic respiratory symptoms, sometimes with multi-organ failure and disseminated intravascular coagulation. Even if it is a rare respiratory disease among children, a good doctor must think about psittacosis as cause of respiratory symptoms (and not only flu or SARS-COV2), above all through a correct medical history, in order to provide a targeted antibiotic therapy. An interesting case of psittacosis in a child is being reported here, which has been treated successfully with doxycillin.
Topics: Animals; Male; Humans; Child; Child, Preschool; Psittacosis; Chlamydophila psittaci; RNA, Viral; COVID-19; SARS-CoV-2; Respiratory Distress Syndrome; Italy; Anti-Bacterial Agents; Pneumonia, Mycoplasma; Chlamydia
PubMed: 37649055
DOI: 10.1186/s13052-023-01497-6 -
Frontiers in Cellular and Infection... 2023To explore the clinical characteristics and prognosis of clustered cases of psittacosis pneumonia.
OBJECTIVE
To explore the clinical characteristics and prognosis of clustered cases of psittacosis pneumonia.
METHOD
We retrospectively analyzed the clinical data of a cluster outbreak of psittacosis pneumonia. The analysis included epidemiological data, clinical symptoms, laboratory results, and prognosis. The diagnosis was made using mNGS and nested PCR technology.
RESULT
Of the four cases, two had direct contact with diseased poultry while the other two did not. All cases presented with more than 39.5 °C fever and chills. Additionally, significant increases in C-reactive protein, ferritin, creatine kinase, and lactate dehydrogenase were observed in all cases, while absolute lymphocyte count decreased. Case 2 also had increased calcitonin levels. Acute respiratory failure occurred during the treatment of case 1 and case 2, leading to tracheal intubation and ventilator-assisted ventilation. Unfortunately, case 2 passed away due to sepsis and multiple organ dysfunction, while the other cases had a positive prognosis.
CONCLUSION
mNGS facilitated the early diagnosis of psittacosis pneumonia. It is important to note that there is still a substantial risk of human-to-human transmission in psittacosis pneumonia. Absolute lymphocyte count and calcitonin levels can predict the severity and prognosis of the disease.
Topics: Humans; Psittacosis; Chlamydophila psittaci; Calcitonin; Retrospective Studies; Pneumonia; Disease Outbreaks
PubMed: 37637462
DOI: 10.3389/fcimb.2023.1214297 -
BMC Infectious Diseases Aug 2023Psittacosis can cause severe community-acquired pneumonia (CAP). The clinical manifestations of psittacosis range from subclinical to fulminant psittacosis with...
INTRODUCTION
Psittacosis can cause severe community-acquired pneumonia (CAP). The clinical manifestations of psittacosis range from subclinical to fulminant psittacosis with multi-organ failure. It is essential to summarize the clinical characteristic of patients with severe psittacosis accompanied by acute hypoxic respiratory failure (AHRF).
METHODS
This retrospective study included patients with severe psittacosis caused CAP accompanied by AHRF from 19 tertiary hospitals of China. We recorded the clinical data, antimicrobial therapy, respiratory support, complications, and outcomes. Chlamydia psittaci was detected on the basis of metagenomic next-generation sequencing performed on bronchoalveolar lavage fluid samples. Patient outcomes were compared between the treatment methods.
RESULTS
This study included 45 patients with severe CAP and AHRF caused by psittacosis from April 2018 to May 2021. The highest incidence of these infections was between September and April. There was a history of poultry contact in 64.4% of the patients. The median PaO/FiO of the patients was 119.8 (interquartile range, 73.2 to 183.6) mmHg. Four of 45 patients (8.9%) died in the ICU, and the median ICU duration was 12 days (interquartile range, 8 to 21) days. There were no significant differences between patients treated with fluoroquinolone initially and continued after the diagnosis, fluoroquinolone initially followed by tetracycline, and fluoroquinolone combined with tetracycline.
CONCLUSION
Psittacosis caused severe CAP seems not rare, especially in the patients with the history of exposure to poultry or birds. Empirical treatment that covers atypical pathogens may benefit such patients, which fluoroquinolones might be considered as an alternative.
Topics: Animals; Humans; Psittacosis; Retrospective Studies; Pneumonia; Community-Acquired Infections; Tetracycline; Poultry; Fluoroquinolones; China; Respiratory Insufficiency
PubMed: 37580698
DOI: 10.1186/s12879-023-08283-z -
Animals : An Open Access Journal From... Jul 2023is an important zoonotic pathogen. Although primarily a pathogen of birds, from which infection can spillover into humans and other mammalian hosts, the importance of...
is an important zoonotic pathogen. Although primarily a pathogen of birds, from which infection can spillover into humans and other mammalian hosts, the importance of as a cause of equine reproductive loss and the risk of infection to humans in contact with infected horses are increasingly being recognised in Australia and elsewhere. Despite the risks to both human and equine health, infection in horses is incompletely understood. This study aimed to update and summarise cases of equine psittacosis in Australia in the period 2018-2022, thus addressing a knowledge gap relating to recent cases in this country. These cases were identified from the examination of records held by state and federal veterinary authorities and from a review of published cases. A total of 31 cases were identified. Spatial and temporal trends were identified, with cases being more prevalent in winter and spring and geographically restricted to Victoria and New South Wales. The results show that cases of equine reproductive loss due to are consistent and ongoing and demonstrate the importance of routinely considering in diagnostic investigations. The need for ongoing study to better understand this important zoonotic pathogen is evident.
PubMed: 37570252
DOI: 10.3390/ani13152443 -
China CDC Weekly Jul 2023
PubMed: 37520447
DOI: 10.46234/ccdcw2023.121 -
IDCases 2023Psittacosis accounts for 1-2 % of community-acquired pneumonia. In recent years, reports of psittacosis are increasing. Most reported cases of psittacosis are sporadic....
Psittacosis accounts for 1-2 % of community-acquired pneumonia. In recent years, reports of psittacosis are increasing. Most reported cases of psittacosis are sporadic. Here, we report a familial cluster of five patients infected with in a northwest Chinese region and share our diagnosis and treatment experience. The epidemiological characteristics, clinical features, laboratory examinations of family cluster psittacosis were collected and analyzed. We closely followed up all the family members and analyzed their clinical outcome. Five cases of family clustered pneumonia were mainly characterized by fever, cough and fatigue. mNGS rapidly identified the infecting agent as in case 1 followed by RT-PCR analysis. A newly purchased pet parrot, which had diarrhea, was probably the primary source of infection. The main change of inflammation index in five patients was the decrease of lymphocyte counts. Chest CT showed peripheral or subpleural involvement of patchy high-density shadows with bronchial ventilation signs and blurred edges, mostly unilateral lesions. Five cases were completely cured with moxifloxacin and azithromycin. Our findings suggest that a familial cluster of infection maybe caused by contact with sick pet parrot or human to human transmission in one close family. For this community-acquired pneumonia, epidemiological characteristics and use of mNGS is very important for improving accuracy in the early diagnosis.
PubMed: 37492645
DOI: 10.1016/j.idcr.2023.e01845 -
Microbial Genomics Jul 2023is a globally distributed veterinary pathogen with zoonotic potential. Although infections have been reported in various hosts, isolation and culture of is...
is a globally distributed veterinary pathogen with zoonotic potential. Although infections have been reported in various hosts, isolation and culture of is challenging, hampering efforts to produce contemporary global genomes. This is particularly evident in the lack of avian genomes from Australia and New Zealand. In this study, we used culture-independent probe-based whole-genome sequencing to expand the global genome catalogue. Here, we provide new genomes from two pigeons, six psittacines, and novel hosts such as the Australian bustard () and sooty shearwater () from Australia and New Zealand. We also evaluated genetic diversity using multilocus sequence typing (MLST) and major outer membrane protein (A) genotyping on additional -positive samples from various captive avian hosts and field isolates from Australasia. We showed that the first genomes sequenced from New Zealand parrots and pigeons belong to the clonal sequence type (ST)24 and diverse 'pigeon-type' ST27 clade, respectively. Australian parrot-derived strains also clustered in the ST24 group, whereas the novel ST332 strain from the Australian bustard clustered in a genetically diverse clade of strains from a fulmar, parrot, and livestock. MLST and A genotyping revealed ST24/A genotype A in wild and captive parrots and a sooty shearwater, whilst 'pigeon-types' (ST27/35 and A genotypes B/E) were found in pigeons and other atypical hosts, such as captive parrots, a little blue penguin/Kororā () and a zebra finch () from Australia and New Zealand. This study provides new insights into the global phylogenomic diversity of and further demonstrates the multi-host generalist capacity of this pathogen.
Topics: Animals; Chlamydophila psittaci; Multilocus Sequence Typing; Feathers; Australia; Psittacosis; Columbidae; Genomics
PubMed: 37486739
DOI: 10.1099/mgen.0.001072 -
Frontiers in Microbiology 2023is a small bacterium often found in birds, including poultry, and domesticated mammals, which causes psittacosis (or parrot fever) in humans. Different strains of...
BACKGROUND
is a small bacterium often found in birds, including poultry, and domesticated mammals, which causes psittacosis (or parrot fever) in humans. Different strains of respond variably to antibiotics, suggesting a possible risk of antibiotic resistance. In general, different genotypes of have relatively stable hosts and different pathogenicity.
METHODS
Macrogenomic sequencing was performed using nucleic acids extracted from psittacosis patients' alveolar lavage fluid samples and analyzed for genetic variability and antibiotic resistance genes. Nucleic acid amplification sequences specific to the core coding region of the gene were used, and a phylogenetic tree was constructed with genotypic sequences from other sources, including Chinese published sources. The found in each patient were genotyped by comparing gene sequences. In addition, to better illustrate the relationship between genotype and host of , 60 bird fecal samples were collected from bird-selling stores for screening and typing.
RESULTS
Macrogenomic sequence alignment revealed the presence of resistance genes in varying abundance in samples from all three patients, including resistance gene sequences from two patients that matched those previously published on NCBI. Based on genotyping, two patients were infected with genotype A and one patient was infected with genotype B. All five -positive samples obtained from bird-selling stores were genotype A. Both genotypes are reported to be infectious to humans. The host origin of the samples and the previously reported main sources of each genotype suggested that all but one of the genotype A in this study were derived from parrots, while genotype B was probably derived from chickens.
CONCLUSION
The presence of bacterial resistance genes in psittacosis patients may affect the efficacy of clinical antibiotic therapy. Focusing on the developmental progression of bacterial resistance genes and differences in the therapeutic efficacy may facilitate effective treatment of clinical bacterial infections. Pathogenicity genotypes (e.g., genotype A and genotype B) are not limited to one animal host, suggesting that monitoring the development and changes of may help prevent transmission to humans.
PubMed: 37425996
DOI: 10.3389/fmicb.2023.1182604 -
Infection and Drug Resistance 2023The incidence of infection has been reported to increase in recent years. The presentation of psittacosis infection varied widely, from none to severe symptoms....
The incidence of infection has been reported to increase in recent years. The presentation of psittacosis infection varied widely, from none to severe symptoms. Mainly, psittacosis infection presents with pulmonary manifestations. Here, we report the case of a 60-year-old female patient with pneumonia complicated by myocarditis. After administering antibiotics, the patient recovered from severe atypical pneumonia and myocarditis. In general, rarely induces myocarditis. Moreover, the optimal therapeutic strategies remain unclear for such cases, especially with a high troponin T level. Metagenomic Next-Generation Sequencing (mNGS) can provide a quick and effective diagnosis of pneumonia; early intervention (antibiotic therapy and nutritional supplements for myocarditis) favors a good outcome, although complications may worsen the condition. Therefore, more studies are required to help improve understanding of the disease.
PubMed: 37409242
DOI: 10.2147/IDR.S417241