Khadka Sulochana, Timilsina Bibek, Pangeni Raju Prasad, Regmi Pradeep Raj, Thapa Anupam Singh
Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Nepal.
HAMS Hospital, Kathmandu, Nepal.
Ann Med Surg (Lond). 2022 Sep 16;82:104695. doi: 10.1016/j.amsu.2022.104695. eCollection 2022 Oct.
Psittacosis, caused by the bacteria Chlamydia psittaci, is primarily a disease of birds that can be transmitted to humans. The clinical manifestations of the disease are wide, ranging from asymptomatic illness to fulminant psittacosis with multi-organ failure. The organism gets attached to the upper respiratory mucosa after inhalation and the majority remain asymptomatic. However, some people may develop symptoms of atypical pneumonia.
Psittacosis usually presents with sudden onset fever with chills and rigor, headache, and myalgia. Here we present a case of a 35 years old female with a history of close contact with parrots who presented to the ER with complaints of high-grade fever and headache for 2 weeks which started 2 days after her parrots died.
The disease usually manifests as flu-like symptoms or pneumonia and is included in the differential diagnosis of community-acquired pneumonia. Investigations reveal neutrophilia, raised erythrocyte sedimentation rate, C-reactive protein, and elevated liver enzymes which were consistent with the findings of our patient. Chest X-ray showed ill-defined consolidation in the right middle and lower lobes which were inconclusive. Hence, a CT chest was done which revealed patchy ground glass opacities with surrounding consolidation giving a reverse halo sign. Due to her contact with birds and CT findings which were suggestive of psittacosis, she was started on doxycycline and her condition improved thereafter.
We highlight the importance of proper history taking and awareness on zoonotic diseases to the general public to prevent, diagnose and treat the disease effectively.
鹦鹉热由鹦鹉衣原体细菌引起，主要是一种可传播给人类的鸟类疾病。该疾病的临床表现广泛，从无症状感染到伴有多器官衰竭的暴发性鹦鹉热。病原体在吸入后附着于上呼吸道黏膜，大多数人仍无症状。然而，有些人可能会出现非典型肺炎的症状。
鹦鹉热通常表现为突然发热、寒战、头痛和肌痛。在此，我们报告一例35岁女性病例，她有与鹦鹉密切接触史，因鹦鹉死后2天出现高热和头痛2周而到急诊室就诊。
该疾病通常表现为流感样症状或肺炎，被纳入社区获得性肺炎的鉴别诊断。检查显示中性粒细胞增多、红细胞沉降率升高、C反应蛋白升高以及肝酶升高，这与我们患者的检查结果一致。胸部X线显示右中、下叶有边界不清的实变影，结果不明确。因此，进行了胸部CT检查，结果显示有斑片状磨玻璃影并伴有周围实变，呈现反晕征。由于她与鸟类接触且CT表现提示鹦鹉热，遂开始使用强力霉素治疗，此后病情好转。
我们强调了详细询问病史以及提高公众对人畜共患病认识对于有效预防、诊断和治疗该疾病的重要性。
