Chlamydophila psittaci: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
===Workup=== | |||
*CBC-leukopenia in 25% of cases | *CBC-leukopenia in 25% of cases | ||
*Chemistry | *Chemistry | ||
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*[[CXR]]-usually lower lobe consolidation | *[[CXR]]-usually lower lobe consolidation | ||
*Sputum culture | *Sputum culture | ||
===Evaluation=== | |||
*Pneumonia is atypical - nonproductive cough, lobar or interstitial infiltrates on CXR. | |||
==Management== | ==Management== | ||
Revision as of 13:29, 5 June 2016
Background
- 6 avian serovars (A-F) and 2 mammalian isolates (WC and M56)
- Reservoirs: birds (465 species), duck, geese, turkeys, cattle, muskrats
- Transmission: inhalation from aerosolized urine, feather dust, feces, dried feces, eye secretions. Person-to-person transmission is possible but rare.
- Incubation period usually 5-14 days but can be up to 1 month
- All transmittable to humans with potential for severe disease
Clinical Features
- Incubation period of 5-14 days
- High fever (up to 40.5C)
- Common: Bradycardia, chills, headache, myalgia, nonproductive staccato cough
- Less common: vomiting, abdominal pain, diarrhea, trace hemoptysis
- Complications: myocarditis, endocarditis, icterus, encephalitis, ARDS, MODs
- Extrapulmonary manifestations - heart, CNS, liver, spleen, kidneys
Differential Diagnosis
Causes of Pneumonia
Bacteria
Viral
- Common
- Influenza
- Respiratory syncytial virus
- Parainfluenza
- Rarer
- Adenovirus
- Metapneumovirus
- Severe acute respiratory syndrome (SARS)
- Middle east respiratory syndrome coronavirus (MERS)
- 2019-nCoV (COVID-19)
- Cause other diseases, but sometimes cause pneumonia
Fungal
- Histoplasmosis
- Coccidioidomycosis
- Blastomycosis
- Pneumocystis jirovecii pneumonia (PCP)
- Sporotrichosis
- Cryptococcosis
- Aspergillosis
- Candidiasis
Parasitic
Lower Respiratory Zoonotic Infections
- Psittacosis
- Anthrax (Bacillus anthracis)
- Brucellosis (Brucella species)
- Q fever (C. burnetti)
- Pasteurellosis (Pasteurella multocida)
- Melioidosis (Burkholderia pseudomallei)
- Rocky Mountain Spotted Fever (R. rickettsii)
- Pulmonic Plague (Yersinia pestis)
- Influenza A
- Hantavirus
Diagnosis
Workup
- CBC-leukopenia in 25% of cases
- Chemistry
- CRP
- LFT
- CXR-usually lower lobe consolidation
- Sputum culture
Evaluation
- Pneumonia is atypical - nonproductive cough, lobar or interstitial infiltrates on CXR.
Management
- Doxycycline 100mg PO Q12h x 10-14 days OR
- Azithromycin 500mg PO Qday x 7 days
- Macrolides (azithromycin, clarithromycin, or erythromycin) for 7-14 days
or
- Tetracyclines (doxycycline 100 mg PO BID) for 7-14 days
Disposition
- Generally may be discharged