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
🦠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…)
🔃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
🧪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)
🦜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
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/
💉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/
![Image](https://pbs.twimg.com/media/Eeq6_MLUcAIfp9v.png)