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Case Report: Clinical analysis of a cluster outbreak of chlamydia psittaci pneumonia
Yinxia Wu1, Xuemei Xu1, Yun Liu1
1Department of Infectious Diseases, Lishui Municipal Central Hospital, Lishui, Zhejiang, China.
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.
Insights
This study investigated a psittacosis pneumonia outbreak, finding human-to-human transmission is a risk. Early diagnosis via mNGS and monitoring lymphocyte counts aids prognosis.
Area of Science:
- Infectious Diseases
- Pulmonology
- Microbiology
Background:
- Psittacosis pneumonia, caused by Chlamydia psittaci, is an uncommon zoonotic infection.
- Understanding the clinical spectrum and outcomes of clustered outbreaks is crucial for public health.
Observation:
- A retrospective analysis of a psittacosis pneumonia cluster revealed four cases with severe symptoms including high fever and chills.
- Key laboratory findings included elevated C-reactive protein, ferritin, creatine kinase, and lactate dehydrogenase, with decreased absolute lymphocyte count.
- Two cases developed acute respiratory failure requiring mechanical ventilation, and one case resulted in mortality from sepsis and multi-organ dysfunction.
Findings:
- Metagenomic next-generation sequencing (mNGS) enabled rapid diagnosis of psittacosis pneumonia.
- Evidence suggests a significant risk of human-to-human transmission in psittacosis pneumonia outbreaks.
- Decreased absolute lymphocyte count and elevated calcitonin levels were identified as potential indicators of disease severity and prognosis.
Implications:
- Early and accurate diagnosis using advanced molecular techniques like mNGS is vital for managing psittacosis pneumonia.
- Awareness of human-to-human transmission potential is critical for implementing effective infection control measures.
- Monitoring specific biomarkers can aid in predicting patient outcomes and guiding clinical management strategies.
