Chlamydia Psittaci infection is rare in pregnancy but can be associated with severe feto-maternal morbidity and mortality. Failure to identify at risk patients may delay diagnosis and appropriate treatment.Case
A 30 year old nulliparous woman presented at 31 weeks gestation with pyrexia, vomiting and malaise. She had no significant past medical or drug history. On examination she was pyrexial, tachycardic and hypoxic. Cardiotocography showed no evidence of foetal compromise. Blood tests revealed an inflammatory picture associated with new anaemia, thrombocytopenia, impaired renal function and deranged liver function enzymes. Chest radiography showed perihilar consolidation. Oxygen therapy, intravenous fluid resuscitation and broad spectrum antibiotics were commenced. Complement fixation testing showed a raised chlamydia psittaci titre. Indirect history revealed exposure to infected parrots at the patient’s place of work as the most likely source of infection. Antibiotics were changed from a broad spectrum regime to macrolide antibiotics; the patient then improved and was discharged 5 days later. Her pregnancy was subsequently uncomplicated and she had a spontaneous onset delivery at 38 weeks gestation.Discussion
Chlamydia Psittaci, whilst rare, should be considered in patients presenting with severe sepsis in pregnancy. When identified early and treated with macrolide antibiotics, feto-maternal morbidity may be prevented. Thorough history taking would allow Obstetricians to identify high risk women and deliver advice to avoid exposure, subsequent infection and adverse outcomes.