Chronicles from the Nest: A Case of Psittacosis in India

Psittacosis is a rare zoonotic disease caused by a gram-negative obligate intracellular bacterium Chlamydia psittaci, which is transmitted through contact with infected birds. It comprises approximately 1% of all community-acquired pneumonia cases. However, this can be just the tip of the iceberg pertaining to the lack of routine testing and awareness of this disease entity, thereby requiring a high index of suspicion for its diagnosis. We report a case of a 37-year-old male presenting with high-grade fever with chills, acute onset of dyspnea, dry cough, arthralgia, and myalgia which was not responding to broad-spectrum empirical antibiotics and supportive care. We started evaluating the patient as a case of pyrexia of unknown origin (PUO), but the fever workup turned out to be inconclusive. This prompted us to revisit the history. It was found that the patient owned a parrot that was sick for the last 15 days. The temporal correlation of the illness with a history of exposure made us suspect psittacosis, which was confirmed by treatment with doxycycline resulting in a drastic improvement in the patient's condition. By this, we want to highlight that history remains the time-tested guide for diagnosing and treating PUO.