A fatal case of hemophagocytic lymphohistiocytosis associated with gestational psittacosis without symptoms of pneumonia

Psittacosis is a zoonotic infection caused by Chlamydia psittaci. Most patients present with acute respiratory symptoms and systemic illness. When C. psittaci infects pregnant women, it causes severe clinical manifestations called gestational psittacosis. Here we report a case of gestational psittac...

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Bibliographic Details
Published in:The journal of obstetrics and gynaecology research 2022-12, Vol.48 (12), p.3325-3330
Main Authors: Yoshimura, Michinobu, Shimizu, Kanako, Nakura, Yukiko, Kawahara, Kazumi, Katano, Harutaka, Motooka, Daisuke, Takeuchi, Makoto, Nagamune, Kisaburo, Imamura, Yoshiaki, Nakamura, Shota, Yasukawa, Kiyoshi, Hasegawa, Hideki, Yoshida, Yoshio, Yanagihara, Itaru
Format: Article
Language:English
Subjects:
C. psittaci
Case reports
Chlamydia psittaci
Differential diagnosis
Fever
gestational psittacosis
hemophagocytic lymphohistiocytosis
Histiocytosis
Lymphatic diseases
Lymphocytosis
Maternal & child health
Medical diagnosis
Paraffin
Patients
Placenta
Pregnancy
Psittacosis
Zoonoses
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Summary:Psittacosis is a zoonotic infection caused by Chlamydia psittaci. Most patients present with acute respiratory symptoms and systemic illness. When C. psittaci infects pregnant women, it causes severe clinical manifestations called gestational psittacosis. Here we report a case of gestational psittacosis. Our patient lacked respiratory symptoms, and pathological postmortem examinations revealed severe placentitis. Both DNA and immunohistochemical analyses were positive for C. psittaci from formalin‐fixed paraffin‐embedded tissues. The chlamydial DNA in the placenta was about 100 times more abundant than that in the lungs; therefore, the placenta rather than the lungs was the probable target of the C. psittaci infection during this pregnancy. We could not identify the source of infection. Gestational psittacosis should be considered in the differential diagnosis for fever of unknown origin during pregnancy, even in cases lacking respiratory symptoms.
ISSN:1341-8076
1447-0756
DOI:10.1111/jog.15429