[A very serious course of psittacosis in pregnancy]

A 33-year-old pregnant woman was admitted because of atypical pneumonia. She developed adult respiratory distress syndrome complicated by premature birth and perinatal mortality. The diagnosis 'psittacosis' was established on clinical grounds and confirmed serologically (complement fixation test). She was treated with doxycycline 200 mg i.v. daily for 3 weeks and was discharged in good condition after three months. Indirect case history revealed infected birds from the neighbours as the likely source of infection. Psittacosis is caused by Chlamydia psittaci and is acquired after inhalation of dry secreta or excreta from infected animals. Retrospective direct questioning often reveals contact with birds. Diagnostic delay can be considerable. Doxycycline is contraindicated in pregnant women, but erythromycine can be prescribed. Pregnant women should be advised to avoid contact with infected birds as they run an increased risk of a severe disease course.