Psittacosis natural history: Difference between revisions
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{{CMG}} ; {{AE}} {{ADI}}{{DAMI}} | {{CMG}} ; {{AE}} {{ADI}}{{DAMI}} | ||
==Overview== | ==Overview== | ||
If left untreated, psittacosis usually presents as [[Flu|flu-like symptoms]] or an [[atypical pneumonia]]. In the first week of [[psittacosis]], the symptoms mimic [[typhoid fever|typhoid fever,]] including prostrating high [[fever]]s, [[arthralgia]]s, [[diarrhea]], [[conjunctivitis]], [[epistaxis]], and [[leukopenia]]. [[Headache]] can be so severe that it suggests [[meningitis]] and some [[nuchal rigidity]]. Towards the end of the first week, [[stupor]] or even [[Coma (patient information)|coma]] can result in severe cases. The second week is more akin to [[acute]] [[Bacteremia|bacteremic]] [[pneumococcal pneumonia]] with continuous high [[fever]]s, [[cough]], and [[dyspnea]]. Some complications include [[respiratory failure]], [[acute tubular necrosis]], [[hemolytic anemia]], [[endocarditis]], [[hepatitis]], [[encephalitis]] and, in some cases, death. | |||
==Natural History, Complications and Prognosis== | ==Natural History, Complications and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
Psittacosis presents chiefly as an [[atypical pneumonia]]. In the first week of [[psittacosis]] the symptoms mimic [[typhoid fever]] | Psittacosis presents chiefly as an [[atypical pneumonia]]. In the first week of [[psittacosis]], the symptoms mimic [[typhoid fever]], including prostrating high [[fever]]s, [[arthralgia]]s, [[diarrhea]], [[conjunctivitis]], [[epistaxis]], and [[leukopenia]]. Severe [[headache]] and the presence of [[nuchal rigidity]] may suggest [[meningitis]]. Towards the end of the first week, stupor and [[coma]] result in severe cases. The second week is more akin to acute [[Bacteremia|bacteremic]] [[pneumococcal pneumonia]] with continuous high [[fever]]s, [[cough]], and [[dyspnea]]. If untreated, psittacosis progresses as following: | ||
* Stage of [[flu]] like syndrome | * Stage of [[flu]]-like syndrome | ||
* Moderate [[pneumonia]] with X ray findings | * Moderate [[pneumonia]] with X-ray findings | ||
* Severe [[pneumonia]] | * Severe [[pneumonia]] | ||
* [[Respiratory failure]] and [[sepsis]] | * [[Respiratory failure]] and [[sepsis]] | ||
===Complications=== | ===Complications=== | ||
Complications that can develop as a result of psittacosis | Complications that can develop as a result of psittacosis include:<ref name="pmid7742452">{{cite journal| author=Verweij PE, Meis JF, Eijk R, Melchers WJ, Galama JM| title=Severe human psittacosis requiring artificial ventilation: case report and review. | journal=Clin Infect Dis | year= 1995 | volume= 20 | issue= 2 | pages= 440-2 | pmid=7742452 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7742452 }} </ref><ref name="pmid1621687">{{cite journal| author=Jeffrey RF, More IA, Carrington D, Briggs JD, Junor BJ| title=Acute glomerulonephritis following infection with Chlamydia psittaci. | journal=Am J Kidney Dis | year= 1992 | volume= 20 | issue= 1 | pages= 94-6 | pmid=1621687 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1621687 }} </ref><ref name="pmid2770941">{{cite journal| author=Timmerman R, Bieger R| title=Haemolytic anaemia due to cold agglutinins caused by psittacosis. | journal=Neth J Med | year= 1989 | volume= 34 | issue= 5-6 | pages= 306-9 | pmid=2770941 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2770941 }} </ref><ref name="pmid2061902">{{cite journal| author=Samra Z, Pik A, Guidetti-Sharon A, Yona E, Weisman Y| title=Hepatitis in a family infected by Chlamydia psittaci. | journal=J R Soc Med | year= 1991 | volume= 84 | issue= 6 | pages= 347-8 | pmid=2061902 | doi= | pmc=1293282 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2061902 }} </ref><ref name="pmid2061902">{{cite journal| author=Samra Z, Pik A, Guidetti-Sharon A, Yona E, Weisman Y| title=Hepatitis in a family infected by Chlamydia psittaci. | journal=J R Soc Med | year= 1991 | volume= 84 | issue= 6 | pages= 347-8 | pmid=2061902 | doi= | pmc=1293282 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2061902 }} </ref><ref name="pmid8463649">{{cite journal| author=Fernández-Guerrero ML| title=Zoonotic endocarditis. | journal=Infect Dis Clin North Am | year= 1993 | volume= 7 | issue= 1 | pages= 135-52 | pmid=8463649 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8463649 }} </ref><ref name="pmid6331560">{{cite journal| author=Lanham JG, Doyle DV| title=Reactive arthritis following psittacosis. | journal=Br J Rheumatol | year= 1984 | volume= 23 | issue= 3 | pages= 225-6 | pmid=6331560 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6331560 }} </ref><ref name="pmid9636859">{{cite journal| author=Lietman T, Brooks D, Moncada J, Schachter J, Dawson C, Dean D| title=Chronic follicular conjunctivitis associated with Chlamydia psittaci or Chlamydia pneumoniae. | journal=Clin Infect Dis | year= 1998 | volume= 26 | issue= 6 | pages= 1335-40 | pmid=9636859 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9636859 }} </ref> | ||
* [[Respiratory failure]] | |||
* [[Acute tubular necrosis]] | |||
* [[Hemolytic anemia]] | |||
* [[Endocarditis]] | |||
* [[Hepatitis]] | |||
* [[Endocarditis]] | |||
* [[Reactive arthritis]] | |||
* Chronic follicular [[conjunctivitis]] | * Chronic follicular [[conjunctivitis]] | ||
*[[Lymphoma]] | *[[Lymphoma]] | ||
*Gestational [[psittacosis]] | *Gestational [[psittacosis]] | ||
* [[Encephalitis]] | * [[Encephalitis]], which is rare but fatal. | ||
===Prognosis=== | ===Prognosis=== | ||
[[Psittacosis]] is a treatable [[infectious disease]]. With appropriate [[antibiotic therapy]], prognosis is good. If the disease is complicated by [[renal failure]] or [[respiratory failure]], prognosis is poor. | [[Psittacosis]] is a treatable [[infectious disease]]. With appropriate [[antibiotic therapy]], the prognosis is good. If the disease is complicated by [[renal failure]] or [[respiratory failure]], the prognosis is poor. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
Latest revision as of 23:51, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]Omodamola Aje B.Sc, M.D. [3]
Overview
If left untreated, psittacosis usually presents as flu-like symptoms or an atypical pneumonia. In the first week of psittacosis, the symptoms mimic typhoid fever, including prostrating high fevers, arthralgias, diarrhea, conjunctivitis, epistaxis, and leukopenia. Headache can be so severe that it suggests meningitis and some nuchal rigidity. Towards the end of the first week, stupor or even coma can result in severe cases. The second week is more akin to acute bacteremic pneumococcal pneumonia with continuous high fevers, cough, and dyspnea. Some complications include respiratory failure, acute tubular necrosis, hemolytic anemia, endocarditis, hepatitis, encephalitis and, in some cases, death.
Natural History, Complications and Prognosis
Natural History
Psittacosis presents chiefly as an atypical pneumonia. In the first week of psittacosis, the symptoms mimic typhoid fever, including prostrating high fevers, arthralgias, diarrhea, conjunctivitis, epistaxis, and leukopenia. Severe headache and the presence of nuchal rigidity may suggest meningitis. Towards the end of the first week, stupor and coma result in severe cases. The second week is more akin to acute bacteremic pneumococcal pneumonia with continuous high fevers, cough, and dyspnea. If untreated, psittacosis progresses as following:
- Stage of flu-like syndrome
- Moderate pneumonia with X-ray findings
- Severe pneumonia
- Respiratory failure and sepsis
Complications
Complications that can develop as a result of psittacosis include:[1][2][3][4][4][5][6][7]
- Respiratory failure
- Acute tubular necrosis
- Hemolytic anemia
- Endocarditis
- Hepatitis
- Endocarditis
- Reactive arthritis
- Chronic follicular conjunctivitis
- Lymphoma
- Gestational psittacosis
- Encephalitis, which is rare but fatal.
Prognosis
Psittacosis is a treatable infectious disease. With appropriate antibiotic therapy, the prognosis is good. If the disease is complicated by renal failure or respiratory failure, the prognosis is poor.
References
- ↑ Verweij PE, Meis JF, Eijk R, Melchers WJ, Galama JM (1995). "Severe human psittacosis requiring artificial ventilation: case report and review". Clin Infect Dis. 20 (2): 440–2. PMID 7742452.
- ↑ Jeffrey RF, More IA, Carrington D, Briggs JD, Junor BJ (1992). "Acute glomerulonephritis following infection with Chlamydia psittaci". Am J Kidney Dis. 20 (1): 94–6. PMID 1621687.
- ↑ Timmerman R, Bieger R (1989). "Haemolytic anaemia due to cold agglutinins caused by psittacosis". Neth J Med. 34 (5–6): 306–9. PMID 2770941.
- ↑ 4.0 4.1 Samra Z, Pik A, Guidetti-Sharon A, Yona E, Weisman Y (1991). "Hepatitis in a family infected by Chlamydia psittaci". J R Soc Med. 84 (6): 347–8. PMC 1293282. PMID 2061902.
- ↑ Fernández-Guerrero ML (1993). "Zoonotic endocarditis". Infect Dis Clin North Am. 7 (1): 135–52. PMID 8463649.
- ↑ Lanham JG, Doyle DV (1984). "Reactive arthritis following psittacosis". Br J Rheumatol. 23 (3): 225–6. PMID 6331560.
- ↑ Lietman T, Brooks D, Moncada J, Schachter J, Dawson C, Dean D (1998). "Chronic follicular conjunctivitis associated with Chlamydia psittaci or Chlamydia pneumoniae". Clin Infect Dis. 26 (6): 1335–40. PMID 9636859.