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21 March 2024 : Case report  China (mainland)

[In Press] Chlamydia psittaci Pneumonia: Diagnosis, Treatment, and Challenges in the Context of COVID-19

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease

Zhengbing Wu1CD, Jun Liu2EF, Shifeng Shao1ABG

DOI: 10.12659/AJCR.942921

Am J Case Rep In Press; DOI: 10.12659/AJCR.942921  

Available online: 2024-03-21, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
Rapid diagnosis is critical for effective treatment of severe pneumonia during the COVID-19 pandemic. Chlamydia psittaci, an atypical community-acquired pathogen, typically exhibits nonspecific clinical signs and requires stringent conditions for microbiological culture, complicating its identification. Metagenomic next-generation sequencing (mNGS), which involves shotgun sequencing of DNA or RNA from clinical samples, is a key technology in clinical settings. Although mNGS technology identifies nucleic acids, it should not be directly equated with the presence of pathogenic microorganisms. Nonetheless, it shows promise as a principal method for detecting atypical pathogens in severe infectious diseases in the future.
CASE REPORT
We present a case of severe community-acquired Chlamydia psittaci pneumonia, highlighting the ongoing mutations and frequent spread of COVID-19. The patient’s severe pulmonary infection rapidly advanced, resulting in multiple organ failure, necessitating extracorporeal membrane oxygenation (ECMO) support. Despite initial inconclusive routine laboratory tests, diagnosis of Chlamydia psittaci pneumonia was confirmed through mNGS. Antibiotic treatment and multi-organ functional support were administered, leading to the patient’s successful recovery and hospital discharge.
CONCLUSIONS
Diagnosing severe pneumonia caused by atypical pathogens amid the COVID-19 pandemic presents significant challenges. Initiating ECMO support without effective infection control poses considerable risks, such as increasing risk of catheter-related infections and antimicrobial treatment failure. In the case presented, mNGS proved instrumental in screening for atypical pathogens in critical infectious diseases. Application of multi-organ function support in reversible conditions affords clinicians time for pathogen identification and treatment, offering novel approaches for diagnosing and treating severe pneumonia induced by unconventional pathogens during epidemic outbreaks.

Keywords: Chlamydophila psittaci; Metagenomics; Prone Position

In Press

29 Feb 2024 : Case report  Greece

Pancreatolithiasis: Does Management Depend on Clinical Manifestations?

Am J Case Rep In Press; DOI: 10.12659/AJCR.942725  

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01 Mar 2024 : Case report  USA

A 25-Year-Old Man with a History of Substance Abuse Presenting with Pneumomediastinum Due to Methamphetamin...

Am J Case Rep In Press; DOI: 10.12659/AJCR.941509  

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01 Mar 2024 : Case report  USA

Complicated Treatment Course of Severe Asymptomatic Hypertriglyceridemia: A Case Report and Literature Review

Am J Case Rep In Press; DOI: 10.12659/AJCR.943858  

04 Mar 2024 : Case report  Switzerland

Unintentional Plastic Blister Ingestion Leading to Intestinal Perforation: A Report of Two Cases

Am J Case Rep In Press; DOI: 10.12659/AJCR.943514  

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923