Inexplicable high fever caused by a parrot

Guangzhou Daily News (all media reporter Zhou Jieying correspondent You Hualing) Recently, the Third Affiliated Hospital of Southern Medical University admitted two patients with persistent high fever. Antibiotics and antipyretics were ineffective. Finally, a rare pathogen was found in the Department of Respiratory Medicine of the Third Hospital of Southern Medical University, and the diagnosis was “psittacosis”. After some inquiry by the doctor, it was learned that the two patients who were ill, one raised chickens and ducks at home, and the other had pet parrots.

Ms. Xiao, 57 years old, had recurrent fever for 2 weeks for unknown reasons. The highest temperature was over 40℃. The condition did not improve after more than ten days of treatment at the nearest hospital. Deputy Chief Physician Cui Haiyan inquired about the patient’s medical history in detail, and admitted the patient to the hospital to check various indicators in detail. All laboratory tests were normal, and culture identification results: blood culture, nine IgM of respiratory pathogens, general bacterial and fungal smears in bronchoalveolar lavage fluid, Mycobacterium tuberculosis antibodies, and Cryptococcus detection showed no obvious abnormality.

What is the reason? Cui Haiyan used a bronchoscope to take the patient’s bronchoalveolar lavage fluid for another test, and found another atypical pathogen, Chlamydia psittaci. At this point, a clear diagnosis was made: Chlamydia psittacosis pneumonia. Cui Haiyan made further inquiries and learned that the patient’s home kept poultry such as chickens and ducks. After the cause was clarified, symptomatic medication was administered, and the patient’s high fever gradually subsided, and the inflammation of the lower lobes of both lungs was reduced compared with before.

Coincidentally, 59-year-old Mr. Zhu also went to the Department of Respiratory Medicine of the Third Hospital of Southern Medical University due to unexplained fever for 3 days. Chest CT showed infection in the upper lobe of the left lung and a small amount of effusion in the left pleural cavity. After a series of examinations to rule out various possibilities, the bronchoalveolar lavage fluid was collected by bronchoscopy for NGS testing, and the result was Chlamydia psittacosis. The patient reported that he had pet parrots at home.

Reminder: Domestic poultry must pay attention to hygiene and do not play for a long time

The two patients recovered quickly and were discharged from the hospital after receiving standard anti-infective treatment. Cui Haiyan introduced that Chlamydia psittacosis infection is a natural foci of disease. Birds and poultry are the main hosts, and most of the transmission routes are contact with aerosols or secretions and excreta containing Chlamydia psittacosis. Typical manifestations include high fever, Chills, muscle aches, headaches, and pulmonary infiltrates may develop into severe pneumonia and multiple organ failure. In the past, due to the limitation of etiological detection technology, the number of clinically diagnosed cases of Chlamydia psittacosis infection was small. If timely and accurate diagnosis and targeted treatment were not performed, the prognosis was often poor.

How can ordinary citizens prevent “parrot fever”? Cui Haiyan suggested that everyone can reduce the feeding of birds and poultry, and if you need to feed them, try to buy them through formal channels. It is recommended that friends who have birds at home should hang the bird cage in an outdoor ventilated place. It is advisable to take 15 to 30 minutes for each viewing time, and keep the indoor air circulation. Pay attention to the hygiene of bird raising and poultry environment, clean regularly, wear masks and gloves when cleaning feces, and apply “wet operation” to prevent dust from flying, so as to prevent pathogenic microorganisms from spreading into the air and being inhaled into the human body. Usually, direct contact with live poultry should be avoided, and edible poultry should be cooked thoroughly.

If you have related symptoms after contact with poultry, don’t panic and seek medical attention in time. Most patients can recover within 1-3 weeks after being diagnosed and taking reasonable medication.