Severe community-acquired pneumonia complicated by co-infection with Chlamydia psittaci and ESBL-producing Escherichia coli: a case report
Abstract
Chlamydia psittaci
is an uncommon but potentially severe cause of community-acquired pneumonia (CAP), typically associated with exposure to birds. Co-infection with multidrug-resistant bacteria is rare and may complicate clinical management.
We report the case of a 71-year-old man with long-term pigeon exposure who presented with high fever, cough, and purulent sputum. He rapidly progressed to severe CAP, type I respiratory failure, and sepsis. Initial routine microbiological tests were negative. Bronchoalveolar lavage fluid metagenomic next-generation sequencing (mNGS) detected
C. psittaci
, and sputum culture grew extended-spectrum beta-lactamase (ESBL)-producing
Escherichia coli
(ESBL-EC). Initial empiric therapy with piperacillin-tazobactam and doxycycline failed to control the disease. After treatment adjustment guided by mNGS and antimicrobial susceptibility testing, including piperacillin–tazobactam, doxycycline, and levofloxacin, combined with respiratory support and organ protection, the patient improved and was discharged.
This case highlights the importance of considering mixed infections, including drug-resistant bacteria, in severe CAP patients with avian exposure who fail empiric therapy. mNGS is a valuable tool for rapid etiological diagnosis in such complex cases. In addition, detection of multidrug-resistant organisms in respiratory samples should be interpreted cautiously, considering colonization, clinical correlation, and therapeutic response.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- GC-MS Analysis and Biomedical Therapy of Oil from n-Hexane Fraction of Scutellaria edelbergii Rech. f.: In Vitro, In Vivo, and In Silico Approach
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.