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Chlamydia psittaci infection-associated acute fibrinous and organizing pneumonitis: A case report
Xianhua Gui1, Xiaohua Qiu1, Yujuan Gao1
1Department of Respiratory and Critical Care Medicine, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China.
Abstract:
Acute fibrinous and organizing pneumonia (AFOP) is a rare type of lung injury, and while Chlamydia psittaci pneumonia is a zoonotic disease, secondary AFOP has not been previously reported. We present a 53-year-old female with a 13-day history of cough, fever, and shortness of breath. High-resolution computed tomography (HRCT) showed multiple bilateral patchy shadows and consolidations in the left lung lower lobe. Empirical treatment was ineffective, and lung lesions worsened. Metagenomic next-generation sequencing (mNGS) confirmed Chlamydia psittaci infection. After minocycline treatment, the patient's fever improved, but shortness of breath persisted. CT-guided lung biopsy revealed "fibrin balls" in the alveolar space and interstitial inflammatory infiltrates. Shortness of breath improved after glucocorticoid therapy, with significant lesion absorption noted on follow-up chest CT. This case suggests a possible association between AFOP and C. psittaci infection, supporting the use of combined antibiotic and glucocorticoid therapy.
Insights
This case highlights a rare instance of acute fibrinous and organizing pneumonia (AFOP) linked to Chlamydia psittaci infection. Combined antibiotic and glucocorticoid therapy proved effective in managing this zoonotic lung injury.
Area of Science:
- Pulmonology
- Infectious Diseases
- Pathology
Background:
- Acute fibrinous and organizing pneumonia (AFOP) is a rare lung injury.
- Chlamydia psittaci pneumonia is a known zoonotic disease.
- Secondary AFOP following C. psittaci infection has not been previously documented.
Observation:
- A 53-year-old female presented with cough, fever, and dyspnea.
- High-resolution CT revealed bilateral lung consolidations.
- Initial empirical treatment failed, and lung lesions progressed.
Findings:
- Metagenomic next-generation sequencing confirmed Chlamydia psittaci infection.
- Minocycline treatment improved fever but not dyspnea.
- Lung biopsy showed "fibrin balls" and interstitial inflammation.
- Glucocorticoid therapy resolved dyspnea and improved CT findings.
Implications:
- This case suggests a potential association between AFOP and C. psittaci infection.
- Combined antibiotic and glucocorticoid therapy may be beneficial for this condition.
- Further research is warranted to explore this link in zoonotic pneumonia.
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