Psittacosis Clinical Presentation

  • Author: Klaus-Dieter Lessnau, MD, FCCP; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Jul 20, 2011
 

History

The incubation period is generally 5-14 days. The longest observed incubation time was 54 days. The predominant presentation is respiratory tract infection with constitutional symptoms. Clinical findings are variable.

  • Constitutional
    • Fever (50-90%)
    • Chills
    • Malaise
  • Respiratory
    • Cough (50-90%), usually not productive
    • Pleuritic chest pain (rare)
    • Dyspnea
    • Sore throat and mild pharyngitis (common)
    • Epistaxis (common)
  • Gastrointestinal
    • Nausea and vomiting (uncommon)
    • Abdominal pain (uncommon)
    • Diarrhea (rare)
    • Jaundice (rare)
  • Neurological
    • Severe headache (common)
    • Photophobia (common)
    • Agitation and lethargy
  • Dermatological - Includes facial rash (Horder spots)
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Physical

Disease may range from mild insidious presentations to severe pneumonia that requires mechanical ventilation.

  • Respiratory
    • Nonspecific auscultatory findings that often underestimate clinical and radiographic findings may develop.
    • Patients may develop fatal pulmonary embolism and pulmonary infarction.
    • Pleural effusion is rare.
  • Cardiac
    • Relative bradycardia is common.
    • Physicians may observe pericarditis, culture-negative endocarditis, and myocarditis.
  • Gastrointestinal
    • Splenomegaly occurs in 10-70% of patients, depending on the study.
    • When present, this sign suggests psittacosis in patients with pneumonia.
  • Neurological
    • Patients may develop meningitis, encephalitis, seizures, and Guillain-Barré syndrome, but these are rare.
    • Cerebrospinal fluid (CSF) findings are usually normal.
  • Dermatological
  • Hematological
  • Renal symptoms include acute glomerulonephritis and tubulointerstitial nephritis.
  • Musculoskeletal symptoms include reactive arthritis that is usually polyarticular. Rarely, rhabdomyolysis has been observed.[2]
  • Stages of disease progression
    • Flulike syndromes without radiographic abnormalities
    • Mild-to-moderate pneumonia
    • Severe pneumonia
    • Acute respiratory failure, sepsis, and septic shock
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Causes

Psittacosis is an infectious disease caused by the obligatory intracellular bacterium C psittaci.

  • C psittaci is associated with psittacine birds and poultry.
  • Psittacosis is an occupational disease of poultry farmers, pet-shop workers, and veterinarians.
  • Relapses may occur.
  • Because psittacosis is a bacterial disease, major protective immunity is unlikely to develop after a single episode of disease. The exact risk of recurrence upon reexposure is unknown. It is reasonable to advise avoidance of infected birds.
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Contributor Information and Disclosures
Author

Klaus-Dieter Lessnau, MD, FCCP  Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory; Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital

Klaus-Dieter Lessnau, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Sepracor None None

Coauthor(s)

Farhad Arjomand, MD  Pulmonary Fellow, Department of Internal Medicine, Division of Pulmonary and Critical Care, Brooklyn Hospital Center, Cornell University School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Kenneth C Earhart, MD  Deputy Head, Disease Surveillance Program, United States Naval Medical Research Unit #3

Kenneth C Earhart, MD is a member of the following medical societies: American College of Physicians, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, and Undersea and Hyperbaric Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Richard B Brown, MD, FACP  Chief, Division of Infectious Diseases, Baystate Medical Center; Professor, Department of Internal Medicine, Tufts University School of Medicine

Richard B Brown, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and Massachusetts Medical Society

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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