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Psittacosis Follow-up

  • Author: Klaus-Dieter Lessnau, MD, FCCP; Chief Editor: Burke A Cunha, MD  more...
 
Updated: Aug 03, 2015
 

Further Outpatient Care

Instruct patients to see a physician if symptoms recur (ie, relapse).

Patients with relapses may need prolonged retreatment (eg, 3-4 wk).

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Further Inpatient Care

Severe infection requires intravenous antibiotics and hospital admission.

Isolation is not indicated during hospital stay.

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Inpatient & Outpatient Medications

Patients may require doxycycline, usually 100 mg IV; alternatively, consider PO administration with the same dose twice a day.

Chloramphenicol is the third drug of choice but is rarely used in the United States.

Consider changing erythromycin from intravenous to oral administration (eg, 500 mg qid).

Chloramphenicol is rarely used in the United States because it may cause agranulocytosis.

Consider changing quinolones from intravenous to oral administration.

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Transfer

Transfer patients with acute respiratory failure to an intensive care unit.

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Deterrence/Prevention

Instruct high-risk individuals to avoid handling newly imported or sick birds.

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Complications

See the list below:

  • Acute respiratory failure
  • Pericarditis
  • Culture-negative endocarditis
  • Renal failure (rare, only a few case reports)
  • Disseminated intravascular coagulation (rare)
  • Arterial embolism (rare, 2 case reports)
  • Reactive arthritis
  • Transverse myelitis
  • Meningitis or encephalitis
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Prognosis

With appropriate antibiotic therapy, the mortality rate is less than 1%.

Hypoxemia and renal failure portend a poor prognosis.

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Patient Education

Warn pet owners and pet-shop and poultry workers to be aware of possible respiratory symptoms and fever.

For excellent patient education resources, visit eMedicineHealth's Sexual Health Center. Also, see eMedicineHealth's patient education article Chlamydia.

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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, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

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.

Dora E Izaguirre, MD Primary Care Physician; Researcher, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital

Dora E Izaguirre, MD is a member of the following medical societies: American Heart Association, American Medical Association, American Public Health Association, Colegio Medico de Honduras

Disclosure: Nothing to disclose.

Jesus Lanza, MD Fellow in Pulmonary and Critical Care Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

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, Massachusetts Medical Society

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, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Acknowledgements

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.

References
  1. Smith KA, Campbell CT, Murphy J, et al. Compendium of measures to control Chlamydophila psittaci infection among humans (psittacosis) and pet birds (avian chlamydiosis), 2010. J Exotic Pet Med. 2011 Jan. 20 (1):32-45. [Full Text].

  2. Smith KA, Bradley KK, Stobierski MG, et al. Compendium of measures to control Chlamydophila psittaci (formerly Chlamydia psittaci) infection among humans (psittacosis) and pet birds, 2005. J Am Vet Med Assoc. 2005 Feb 15. 226(4):532-9. [Medline].

  3. Centers for Disease Control and Prevention. Notifiable Diseases and Mortality Tables. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5906md.htm. Accessed: March 4, 2013.

  4. Matsushima H, Takayanagi N, Ubukata M, et al. [A case of fulminant psittacosis with rhabdomyolysis]. Nihon Kokyuki Gakkai Zasshi. 2002 Jul. 40(7):612-6. [Medline].

  5. Dickx V, Van Droogenbroeck C, Van Vaerenbergh B, Herman P, Braeckman L, Vanrompay D. Chlamydia psittaci, causative agent of avian chlamydiosis and human psittacosis: risk assessment and biosafety recommendations for laboratory use. Applied Biosafety. 2012. 17(2):82-8.

  6. Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices Advisory Committee. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Available at http://www.cdc.gov/hicpac/pdf/isolation/isolation2007.pdf. Accessed: March 4, 2013.

  7. Committee of the National Association of State Public Health Veterinarians. Compendium of measures to control Chlamydia psittaci infection among humans (psittacosis) and pet birds (avian chlamydiosis), 2000. Centers for Disease Control and Prevention. Morbidity Mortality Weekly Reports. 2000. 49:3-17. [Medline].

  8. Coutts II, Mackenzie S, White RJ. Clinical and radiographic features of psittacosis infection. Thorax. 1985 Jul. 40(7):530-2. [Medline].

  9. Crosse BA. Psittacosis: a clinical review. J Infect. 1990 Nov. 21(3):251-9. [Medline].

  10. Cunha BA. Atypical pneumonias. Clinical diagnosis and empirical treatment. Postgrad Med. 1991 Oct. 90(5):89-90, 95-8, 101. [Medline].

  11. Cunha BA. Atypical pneumonias. Conn RB, Borer WZ, Snyder JW, eds. Current Diagnosis. WB Saunders Co; 1996.

  12. Cunha BA. The atypical pneumonias: clinical diagnosis and importance. Clin Microbiol Infect. 2006 May. 12 Suppl 3:12-24. [Medline].

  13. Cunha BA. The chlamydial pneumonias. Drugs Today (Barc). 1998 Dec. 34(12):1005-12. [Medline].

  14. Cunha BA, Ortega AM. Atypical pneumonia. Extrapulmonary clues guide the way to diagnosis. Postgrad Med. 1996 Jan. 99(1):123-8, 131-2. [Medline].

  15. De Schrijver K. A psittacosis outbreak in Belgian customs officers. Euro Surveillance. 1995. Sep:3. [Medline].

  16. Elliott JH. Psittacosis. A flu like syndrome. Aust Fam Physician. 2001 Aug. 30(8):739-41. [Medline].

  17. Entrican G, Brown J, Graham S. Cytokines and the protective host immune response to Chlamydia psittaci. Comp Immunol Microbiol Infect Dis. 1998 Jan. 21(1):15-26. [Medline].

  18. Gherman RB, Leventis LL, Miller RC. Chlamydial psittacosis during pregnancy: a case report. Obstet Gynecol. 1995 Oct. 86(4 Pt 2):648-50. [Medline].

  19. Gregory DW, Schaffner W. Psittacosis. Semin Respir Infect. 1997 Mar. 12(1):7-11. [Medline].

  20. Heddema ER, Kraan MC, Buys-Bergen HE, et al. A woman with a lobar infiltrate due to psittacosis detected by polymerase chain reaction. Scand J Infect Dis. 2003. 35(6-7):422-4. [Medline].

  21. Hughes C, Maharg P, Rosario P, Herrell M, Bratt D, Salgado J, et al. Possible nosocomial transmission of psittacosis. Infect Control Hosp Epidemiol. 1997 Mar. 18(3):165-8. [Medline].

  22. Hughes P, Chidley K, Cowie J. Neurological complications in psittacosis: a case report and literature review. Respir Med. 1995 Oct. 89(9):637-8. [Medline].

  23. Jaton K, Greub G. [Chlamydia: diagnostic and treatment]. Rev Med Suisse. 2005 Mar 30. 1(13):895-8, 901-3. [Medline].

  24. Johnson DH, Cunha BA. Atypical pneumonias. Clinical and extrapulmonary features of Chlamydia, Mycoplasma, and Legionella infections. Postgrad Med. 1993 May 15. 93(7):69-72, 75-6, 79-82. [Medline].

  25. Kirchner JT. Psittacosis. Is contact with birds causing your patient's pneumonia?. Postgrad Med. 1997 Aug. 102(2):181-2, 187-8, 193-4. [Medline].

  26. MacLaren G, Pellegrino V, Butt W, et al. Successful use of ECMO in adults with life-threatening infections. Anaesth Intensive Care. 2004 Oct. 32(5):707-10. [Medline].

  27. Matsui T, Nakashima K, Ohyama T, et al. An outbreak of psittacosis in a bird park in Japan. Epidemiol Infect. 2008 Apr. 136(4):492-5. [Medline].

  28. Nash TW, Murray HW. The atypical pneumonias. Fishman AP, ed. Pulmonary diseases and disorders. 2nd ed. New York, NY: McGraw-Hill; 1998. Vol 2: 1619-24.

  29. Oldach DW, Gaydos CA, Mundy LM, et al. Rapid diagnosis of Chlamydia psittaci pneumonia. Clin Infect Dis. 1993 Sep. 17(3):338-43. [Medline].

  30. Raso Tde F, Godoy SN, Milanelo L, et al. An outbreak of chlamydiosis in captive blue-fronted Amazon parrots (Amazona aestiva) in Brazil. J Zoo Wildl Med. 2004 Mar. 35(1):94-6. [Medline].

  31. Schlossberg D. Chlamydia psittaci (psittacosis). Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000. 2004-6.

  32. Schlossberg D, Delgado J, Moore MM, et al. An epidemic of avian and human psittacosis. Arch Intern Med. 1993 Nov 22. 153(22):2594-6. [Medline].

  33. Stamm WE. Chlamydial infection: psittacosis. Braunwald E, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw Hill; 1998. 1055-64.

  34. Telfer BL, Moberley SA, Hort KP, et al. Probable psittacosis outbreak linked to wild birds. Emerg Infect Dis. 2005 Mar. 11(3):391-7. [Medline].

  35. The latest from the IVD industry December 2004. Chlamydia--pathogens that are still often underestimated. Clin Lab. 2005. 51(3-4):225-9. [Medline].

  36. Tong CY, Sillis M. Detection of Chlamydia pneumoniae and Chlamydia psittaci in sputum samples by PCR. J Clin Pathol. 1993 Apr. 46(4):313-7. [Medline].

  37. Verweij PE, Meis JF, Eijk R, et al. Severe human psittacosis requiring artificial ventilation: case report and review. Clin Infect Dis. 1995 Feb. 20(2):440-2. [Medline].

  38. Wong KH, Skelton SK, Daugharty H. Utility of complement fixation and microimmunofluorescence assays for detecting serologic responses in patients with clinically diagnosed psittacosis. J Clin Microbiol. 1994 Oct. 32(10):2417-21. [Medline].

  39. Psittacosis. Available at http://www.cdc.gov/pneumonia/atypical/psittacosis.html. Accessed: February 7, 2014.

  40. Psittacosis. Available at http://www.health.ny.gov/diseases/communicable/psittacosis/fact_sheet.htm. October 2011; Accessed: 8/2/2015.

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