A 44-yr-old man is admitted with right-sided pneumonia. According to him he has been unwell for three to four days with malaise, fever, cough and muscular pain. He also has a rash on his abdomen and neck pain.
He was previously fit and has not traveled abroad. He is a plumber and also keeps pigeons. According to his wife, two of his favorite pigeons died two weeks ago.
Which organism would you be suspicious of as being responsible for his pneumonia?
A. Streptococcus pneumonia
B. Legionella pneumophila
C. Coxiella burnetii
D. Chlamydia psittaci
E. Mycoplasma pneumoniae
Answer:
D) Chlamydia psittaci
Discussion: Chlamydia psittaci (psittacosis) is characterized by malaise, fever, myalgias and pneumonia. Exposure to an ill bird and a rash (Horder’s spots) are pathognomonic. In the context of his history, Chlamydia would be very high on the index of suspicion.
Erythromycin or tetracyclines are the drugs of choice.
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