Psittacosis

Question 1

Causative organism?

Answer 1

Chlamydia psittaci

Question 2

When should psittacosis be suspected?

Answer 2

When the patient has an atypical pneumonia with a history of bird contact

Question 3

How does transmission occur?

Answer 3

Transmission is typically from birds or bird secretions including urine and faeces, typically occurring after cleaning bird cages

Question 4

Symptoms?

Answer 4

Patients typically present with a subacute onset of:

• Flu-like symptoms (90%): fever, headache and myalgia
• Respiratory symptoms (82%): dyspnoea, dry cough and chest pain

Question 5

Signs?

Answer 5

• Chest: unilateral crepitations and vesicular breathing (common), evidence of pleural effusion (uncommon)
• Abdomen: hepatomegaly and splenomegaly (rare)

Question 6

Investigations?

Answer 6

• Raised inflammatory markers
• Chest X-ray: consolidation (90%)
• Confirmation with serology (usually as part of atypical pneumonia screening)

Question 7

1st line treatment?

Answer 7

Tetracyclines e.g. doxycycline

Question 8

2nd line treatment?

Answer 8

Macrolides e.g. erythromycin