1/
A couple (55M/52F) p/w fever 39F, myalgias, dry cough, and mild diarrhea. Pt and his wife love their pet cockatiels (Charlie + Angel). You dx psittacosis!
Pts ask what should happen to their 🦜🦜, what do you say? #MedTwitter #IDTwitter #IDMedEd
A couple (55M/52F) p/w fever 39F, myalgias, dry cough, and mild diarrhea. Pt and his wife love their pet cockatiels (Charlie + Angel). You dx psittacosis!
Pts ask what should happen to their 🦜🦜, what do you say? #MedTwitter #IDTwitter #IDMedEd
2/
Let's learn about psittacosis in humans before we get to the poll answer!
🦠Chlamydia psittaci
🧫Obligate intracellular GN bacteria
🔹22 cases were reported in 2018 to CDC NNDS
🦜Birds are primary zoonotic reservoir (altho has been seen in other animals eg sheep, cattle)
Let's learn about psittacosis in humans before we get to the poll answer!
🦠Chlamydia psittaci
🧫Obligate intracellular GN bacteria
🔹22 cases were reported in 2018 to CDC NNDS
🦜Birds are primary zoonotic reservoir (altho has been seen in other animals eg sheep, cattle)
3/
🦠C.psittaci documented in >450 spp of birds
🦜Most human inf = pet psittacine 🦜(parakeet/cockatiel/cockatoo/parrot)
🔹Also seen: 🦃,🐔,🦆 , pigeon etc
💥Outbreaks related to pet shops, aviaries, vet facilities, poultry processing (2018, 🐔plant➡️ncbi.nlm.nih.gov/pmc/articles/P…)
🦠C.psittaci documented in >450 spp of birds
🦜Most human inf = pet psittacine 🦜(parakeet/cockatiel/cockatoo/parrot)
🔹Also seen: 🦃,🐔,🦆 , pigeon etc
💥Outbreaks related to pet shops, aviaries, vet facilities, poultry processing (2018, 🐔plant➡️ncbi.nlm.nih.gov/pmc/articles/P…)
4/
🔃Transmit via inhalation of aerosolized dried bird droppings usually
🔹Can occur w/bird secretions/bites, transient exposures
🩺Leads to atypical pna sxs (fever, HA, myalgias, dry cough). Sometimes pharyngitis, diarrhea, LFT changes
▪️Incubation: 5-14d
🔃Transmit via inhalation of aerosolized dried bird droppings usually
🔹Can occur w/bird secretions/bites, transient exposures
🩺Leads to atypical pna sxs (fever, HA, myalgias, dry cough). Sometimes pharyngitis, diarrhea, LFT changes
▪️Incubation: 5-14d
5/
Severe fulminant cases are infrequent but possible (resp failure, septic shock, ARF)
Atypical pnas can be difficult to differentiate clinically. Outside of the right epi hx, a severe headache might be a noticeable difference compared to other atypicals
Severe fulminant cases are infrequent but possible (resp failure, septic shock, ARF)
Atypical pnas can be difficult to differentiate clinically. Outside of the right epi hx, a severe headache might be a noticeable difference compared to other atypicals
6/
🧪Dx: Serology. Cx is discouraged given risk of lab transmission
💊Tx:
▪️Preferred = Tetracyclines (Doxy x 14d)
▪️Proposed alternatives = Macrolides, FQ (mostly based on in vitro activity, limited clinical experience)
🧪Dx: Serology. Cx is discouraged given risk of lab transmission
💊Tx:
▪️Preferred = Tetracyclines (Doxy x 14d)
▪️Proposed alternatives = Macrolides, FQ (mostly based on in vitro activity, limited clinical experience)
7/
🦜Psittacosis can be cured/suppressed in birds with abxs, so no need to do more to prevent recurrent human infection!
🔖Anecdotally, pet shop owners add tetracycline to drinking water of birds for sale to keep them in good health until they are relocated in less crowded cages
🦜Psittacosis can be cured/suppressed in birds with abxs, so no need to do more to prevent recurrent human infection!
🔖Anecdotally, pet shop owners add tetracycline to drinking water of birds for sale to keep them in good health until they are relocated in less crowded cages
8/
Crowded conditions for🦜➡️⬆️shedding of orgs
For outbreaks, will need epi investigation fr source bird (esp if bought w/i past 2 mo)
Otherwise, aviaries/poultry plants/etc have cleaning guidelines/techniques to ⬇️aerosolization of infected particles
pubmed.ncbi.nlm.nih.gov/28891690/
Crowded conditions for🦜➡️⬆️shedding of orgs
For outbreaks, will need epi investigation fr source bird (esp if bought w/i past 2 mo)
Otherwise, aviaries/poultry plants/etc have cleaning guidelines/techniques to ⬇️aerosolization of infected particles
pubmed.ncbi.nlm.nih.gov/28891690/
9/
💉There's no vaccine for birds quite yet, so that is not an option.
Check out a great review and illustrative case here: pubmed.ncbi.nlm.nih.gov/20171542/
💉There's no vaccine for birds quite yet, so that is not an option.
Check out a great review and illustrative case here: pubmed.ncbi.nlm.nih.gov/20171542/
