psittacosis (ornithosis, parrot fever)
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Etiology
Epidemiology
- bird exposure
- inhalation of urine or droppings from birds
- 1% of community-acquired pneumonia
Clinical manifestations
- incubation period 1-6 weeks
- myalgias
- fever
- headache
- pharyngitis
- lethargy
- confusion
- delirium
- splenomegaly (1-10%)
- community-acquired pneumonia: pulmonary symptoms are late & mild
Laboratory
- neutropenia (25%)
- increased serum creatine kinase
- Chlamydophila psittaci antigen
- Chlamydophila psittaci DNA
- Chlamydophila psittaci serology
- four-fold rise in complement fixation titer over > 2 weeks
- culture for Chlamydophila psittaci
- organism is fastidious, thus difficult to culture[2]
- Chlamydophila psittaci in placenta by electron microscopy
Radiology
- chest X-ray
- patchy unilateral or bilateral lower lobe pneumonia
- occasional pleural effusions are small
Differential diagnosis
- pigeon breeder's or bird fancier's lung (hypersensitivity pneumonitis)
- Chlamydophila pneumoniae
- Mycoplasma pneumoniae