Full-term pregnancy after severe gestational psittacosis: a case report and literature review

Gestational psittacosis is a rare but high-risk infection caused by Chlamydia psittaci, often leading to severe maternal complications and adverse fetal outcomes. We report a unique case of a 30-year-old woman at 22 + 5 weeks of gestation who presented with acute high fever and respiratory failure following bird exposure. The diagnosis of C. psittaci infection was rapidly confirmed via blood metagenomic next-generation sequencing (mNGS). Following multidisciplinary consultation involving obstetricians, infectious disease specialists, intensivists, respiratory physicians, clinical pharmacists, and neonatologists, an individualized management plan was established to balance maternal infection control, respiratory support, fetal monitoring, and medication safety during pregnancy. The patient was treated with intravenous azithromycin combined with corticosteroids, and her clinical condition stabilized within 2 weeks. Notably, the pregnancy continued to term, resulting in the delivery of a healthy male infant. To our knowledge, this represents the first reported case worldwide of a successful full-term delivery following gestational psittacosis. This case underscores the critical importance of early mNGS-based diagnosis, multidisciplinary collaboration, and appropriate antimicrobial therapy in optimizing maternal and neonatal outcomes, providing a valuable clinical reference for managing this life-threatening zoonosis during pregnancy.