Carella G, Marra L, Vallot T
Institut de Pathologie médicale, Université Catholique du Sacré Coeur, Rome.
Presse Med. 1996 Feb 10;25(5):197-8.
Psittacosis marked by liver and spleen involvement and minimal pericarditis was observed in an 18-year-old patient hospitalized for fever of 1 month duration. At admission, there was no other clinical manifestation and the chest X-ray showed no sign of pulmonary involvement. Liver tests revealed cholestasis. Ultrasonography of the abdomen revealed multiple nodular formations in the liver and spleen, images confirmed on computed tomography. Liver biopsy showed granulomatous with hyperplasia of the Kupffer cells surrounded by healthy tissue. Complement fixation to psittacosis antigen was positive and increased significantly over a 15-day interval. Treatment with tetracycline led to rapid remission of the fever and normalization of the liver tests and hepatic images. Liver involvement in psittacosis is not uncommon, but this is apparently the first case reporting echographic anomalies. The absence of pulmonary involvement has been reported earlier in a few cases. The diagnosis is usually suggested on the basis of epidemiologic criteria and confirmed by complement fixation.
一名18岁患者因持续发热1个月入院，被诊断为鹦鹉热，伴有肝脏和脾脏受累，心包炎轻微。入院时无其他临床表现，胸部X光检查未显示肺部受累迹象。肝功能检查显示胆汁淤积。腹部超声检查发现肝脏和脾脏有多个结节状病变，计算机断层扫描证实了这些图像。肝活检显示肉芽肿，库普弗细胞增生，周围为健康组织。鹦鹉热抗原补体结合试验呈阳性，并在15天内显著升高。四环素治疗使发热迅速缓解，肝功能检查和肝脏图像恢复正常。肝脏受累在鹦鹉热中并不少见，但这显然是首例报告超声异常的病例。此前已有少数病例报告无肺部受累情况。诊断通常根据流行病学标准做出，并通过补体结合试验确诊。
