Chlamydia psittaci pneumonia without cough: recovery, case report and literature review

We report a case of Chlamydia psittaci pneumonia in a patient presenting with high fever and generalized myalgia but no cough. As infections with Chlamydia psittaci are potentially misdiagnosed and non-responsive to empirical antibiotic treatment, this report aims to enhance the awareness among the healthcare providers.

A 34-year-old male patient developed high fever and fatigue after exposure to poultry. He presented to the hospital for treatment. Chest computed tomography (CT) showed a high-density shadow in the deep area of the left lower lung. Sputum culture returned negative. Empirical treatment with multiple antibiotics was given. No improvement was observed in the patient's condition. Next-generation sequencing (NGS) was performed on bronchoalveolar lavage fluid. It confirmed the diagnosis of Chlamydia psittaci infection. The lesion was located deeply. The clinical team promptly adjusted the antibiotic regimen. Intensive pulmonary rehabilitation training was added simultaneously. It facilitated the drainage of deep-seated sputum. The patient finally achieved complete recovery and was discharged.

This case report indicates that in patients with high fever, clinicians should first determine the etiological factors and identify the lesion site. Accurate diagnosis can thus be achieved. In this case, the lesion was deeply located in the lung. Even with sensitive antibiotics, complete elimination of the lesion was difficult. Therefore, active pulmonary rehabilitation intervention should be implemented promptly. It promotes airway clearance, sputum excretion, and secretion drainage. It also accelerates the patient's recovery process.