Clinical experience with fluoroquinolones for treatment of severe Chlamydia psittaci pneumonia with invasive mechanical ventilation in ICU: a retrospective study

TL;DR

This study examines the effectiveness of fluoroquinolones in treating severe Chlamydia psittaci pneumonia requiring ICU ventilation.

Contribution

The study provides clinical evidence supporting fluoroquinolones as a treatment for severe C. psittaci pneumonia in ICU settings.

Findings

Most patients showed high fever, shortness of breath, and elevated inflammatory markers.

Fluoroquinolone-based treatment led to recovery in all 14 ICU patients with severe C. psittaci pneumonia.

Clinical features included consolidation, exudation, and pleural effusion on chest imaging.

Abstract

In this study, we sought to investigate the clinical manifestations, laboratory findings and radiographic features of severe Chlamydia psittaci pneumonia requiring invasive mechanical ventilation in the intensive care unit (ICU), as well as evaluate the role of fluoroquinolones in its treatment.

We retrospectively reviewed the clinical data of 14 patients diagnosed with severe C. psittaci pneumonia at Zhejiang University School of Medicine, Sir Run Run Shaw Hospital from December 2018 to November 2022. We collected the clinical characteristics, laboratory examination results, imaging features, treatment and prognosis. We used the SPSS 26.0 software to perform statistical analysis.

Most patients presented high fever (≥39 °C), shortness of breath and cough, as well as extrapulmonary symptoms such as fatigue, dizziness, muscle pain and headache. There were also significant increases in white blood cells, C-reactive protein (CRP), procalcitonin (PCT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and D-dimer, while lymphocytes decreased significantly. Primary chest imaging features included consolidation, exudation and pleural effusion. All 14 patients received fluoroquinolones-based treatment and recovered.

The clinical manifestations of severe C. psittaci pneumonia are nonspecific. Fluoroquinolones-based treatment may be effective in severe C. psittaci pneumonia with invasive mechanical ventilation in ICU. For severe cases of C. psittaci pneumonia, the treatment regimen may require an intravenous fluoroquinolone-based approach.