Early identification of mild Chlamydia psittaci pneumonia in fever clinic
Objective:To report our experience with early recognition of mild Chlamydia psittaci pneumonia in fever clinic.Methods:Clinical data of 13 cases of mild Chlamydia psittaci pneumonia who visited the Fever Clinic of Peking University Third Hospital from June 2021 to August 2022 were retrospectively analyzed. The diagnosis was confirmed by metagenomic next generation sequencing (mNGS) after admission. Clinical data collected included history of exposure to poultry and birds, clinical symptoms, routine blood tests, and chest CT images.Results:All the patients (100%) had a history of direct exposure to parrots or pigeons and fever, with 6 cases (46.2%) complicated with dry cough and 8 (61.5%) with obvious headache. The median time from symptoms to the visit of fever clinic was 3 days. The median white blood cell count was 6.92×109/L (range, 5.04×109/L-8.42×109/L), and the median percentage of neutrophils was 76.4% (range, 71.2%-84.8%). Chest CT findings consisted of consolidation (7 cases, 53.8%), nodules (4 cases, 30.8%), and mass (2 cases, 15.4%), which were mainly found in the periphery (10 cases, 76.9%) of one lobe (12 cases, 92.3%) in a single lung (100%) and were often accompanied by surrounding ground glass shadows (11 cases, 84.6%) and internal air bronchogram (11 cases, 84.6%). Bronchial wall thickening (1 case, 7.7%), centrilobular nodules (1 case, 7.7%), and pleural fluid (1 case, 7.7%) was infrequently observed.Conclusion:Chlamydia psittaci pneumonia should be considered when patients visit fever clinic with a history of exposure to parrots or pigeons, fever with nonproductive cough or prominent headache, normal white blood cell count, and consolidation in the periphery of the lower lobe of a single lung on chest CT images.
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