INFECTIONS BY ORGANISMS OF PSITTACOSIS/LYMPHOGRANULOMA VENEREUM GROUP IN THE WEST OF SCOTLAND

Chlamydial infections of the heart

Chlamydiae are common human pathogens, causing a broad spectrum of infectious diseases. Chlamydial infections involving the heart have been described in numerous previous reports. These organisms are documented to cause endocarditis, myocarditis and pericarditis. Furthermore, Chlamydia pneumoniae, the recently discovered respiratory pathogen, has also been implicated in coronary artery disease. For the first time the literature on involvement of the heart in chlamydial infections is reviewed. Information on the discovery of Chlamydia species is also included and the problem of the species determination of Chlamydia in interpretation of the older literature is mentioned.

Psittacosis: a clinical review

The records of the Public Health Laboratory at Leeds were searched and cases in which a four-fold rise of antibodies to Chlamydia psittaci had occurred were reviewed. Clinical and epidemiological features of these cases are presented. The importance of birds as a potential source of infection is emphasised.

Successful treatment by doxycycline of endocarditis caused by ornithosis

The case of a 59 year old man with ornithosis endocarditis and a history of contact with pheasants is reported. Treatment with oxytetracycline was not tolerated and so doxycycline was substituted. Over the two year follow up the patient's clinical condition and serial echocardiographic appearances improved and Chlamydia psittaci complement fixation titres returned to normal. Valve replacement was not required.

Pericardial effusion complicating psittacosis infection

A 13-year-old schoolboy developed a moderately large pericardial effusion during the course of infection with psittacosis. The value of echocardiography in differentiating between pericardial effusion and myocarditis is shown.

Fulminant psittacosis

Two patients died of psittacosis after presenting with generalised toxaemia, acute renal failure, and evidence of pancreatitis. Death was attributed to the virulence of the chlamydial strain and the delay in antemortem diagnosis. In one case Chlamydia psittaci was isolated from necropsy lung tissue. A third case of psittacosis suggested person-to-person or fomite spread, which is rarely reported. Infection was acquired from an apparently healthy, imported and quarantined cockatiel. Import restrictions on psittacines should thus be tightened and psittacosis should be made a notifiable disease.

Endocarditis as a manifestation of Chlamydia B infection (psittacosis)

A case of Chlamydia B (psittacosis) endocarditis is described in a patient with no known previous valve disease. After mitral valve replacement a fall in Chlamydia B antibody titre occurred. At repeat mitral valve replacement five months later for a paravalve leak no evidence of continuing endocarditis was present. Direct confirmation of infection in the patient's apparently healthy budgerigar was obtained. Aspects of the pathogenesis, diagnosis, and treatment are discussed.

Endocarditis caused by a psittacosis agent

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Ornithosis in Somerset. Experience in the South Somerset clinical area 1964-71

During an 8-year period, seventy patients were found, by complement fixation testing, to have had ornithosis. A clinical analysis was made of forty-seven who fulfilled strict diagnostic criteria; thirty-three had been referred to a chest clinic, fourteen had been hospitalized. A non-specific, febrile, myalgic illness with respiratory symptoms was the usual clinical syndrome; cough was a prominent, often dramatic, symptom. Pulmonary crepitations, variable radiographic changes, and a normal white blood cell count were found to be useful diagnostic features. Ornithosis sometimes masqueraded as major chest disease, and could be debilitating. Careful retrospective interrogation revealed significant bird contacts in the majority of patients. Treatment with a tetracycline was of possible clinical benefit.

Pericardial and myocardial disease associated with serological evidence of infection by agents of the psittacosis-lymphogranuloma venereum group (Chamydiaceae)

Nine patients with acute pericarditis or myocarditis, or both, were found to have serological evidence of concurrent infection by a psittacosis agent. Three patients had conclusive epidemiological and clinical evidence of complicating pulmonary psittacosis and demonstrated that psittacosis agent does produce inflammatory heart disease in this geographic area.

Six patients had imperfect corroborative evidence of psittacosis and their clinical manifestations were atypical. Indeed, half of these patients were initially believed to have some form of idiopathic myocardial disease. Studies of these patients suggest that psittacotic infection m ay be causal in certain forms of heart disease commonly designated primary myocardial disease.

Cardiac involvement in psittacosis

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