[Severe course of ornithosis and its intensive care and diagnostic problems--a case report]

Ornithosis is still a life-threatening illness unless diagnosed early and adequately treated with antibiotics. Diagnosis, however, is difficult because often no direct contact with birds is obvious. We report on the course of a severe case of ornithosis in a 45-year-old man who had no previous health problems. Infection with Chlamydia psittaci probably occurred by inhaling of contaminated dust produced by flocks of wild pigeons. A special feature of the case is that commonly used serological tests (complement fixation reaction, CFR; ELISA) failed to yield clear results. Since propagation of Chlamydia psittaci requires special biological laboratory containment facility no. 3, we were able to detect the pathogen in faeces, blood, and urine using the direct immunofluorescence antibody technique (DIFT) and a modified peroxidase antiperoxidase technique (PAP). A lot of Chlamydia psittaci was found. These results were verified by electron microscopy. As a result, the treatment could be quickly adjusted to the application of doxycyclin, which led to a rapid improvement in the patient's condition. This direct detection of Chlamydia psittaci by DIFT, the PAP technique or electron microscopy, also in faeces, blood and urine specimens, represents a useful addition to the usual microbiological methods for the diagnosis of this pathogen.