Severe Chlamydia psittaci Pneumonia Complicated by Rhabdomyolysis: A Case Series

Figures & data

Table 1 Clinical Characteristics and Laboratory Data of the Four Patients

Items	Case 1	Case 2	Case 3	Case 4
Sex, age (years)	Male, 64	Male, 54	Male, 46	Male, 56
History of bird contact	Parrots	Dead birds	Geese	Chickens
Underlying diseases	Diabetes	Coronary heart disease, hypertension	Hypertension	None
Symptoms	Fever, fatigue, muscle soreness, cough, expectoration, nausea, and vomiting	Fever, fatigue, muscle soreness, cough, poor consciousness	Fever, fatigue, muscle soreness, cough, expectoration, shortness of breath, diarrhea	Fever, fatigue, cough, expectoration
HCO3 (normal: 22–28 mmol/L)	19.54	29.6	24.4	22.3
WBC (normal: 4–10×10^9/L)	13.31	3.2	6.17	5.88
Absolute neutrophil count(normal:2–7×10^9/L)	12.05	2.28	5.45	4.76
Neutrophil percentage (normal: 50–70%)	90.5	88.2	88.3	80.6
CRP (normal: 0–8 mg/L)	89	229.5	179.96	147.79
PCT (normal: 0–5 ng/mL)	4.75	4.26	1.16	1.15
CK (normal: 26–174 U/L)	20,252	7659	2363	5066
CK-MB (normal:0–24U/L)	23	19	20	17
High-sensitivity troponin T(normal:0–14ng/L)	13	11	12	11.53
Myoglobin (normal: 0–110 ng/mL)	823.13	613.5	867.5	534.21
BNP (normal: 0–100 pg/mL)	4246	1669	1461	1388
AST (normal: 13–40 U/L)	348	258	81.7	141
ALT (normal: 5–40 U/L)	70	72	48.4	141
LDH (normal: 0–247 U/L)	576	669	461	388
Cr (normal: 59–104 µmol/L)	178	257	111	137
Urea (normal: 3.2–7.1 µmol/L)	11.34	12.02	8.21	10.3
eGFR(normal:80–120 mL/min)	34.69	23.87	69.69	50.36
Ca (normal: 2.25–2.75 mmol/L)	1.87	1.74	1.68	1.85
P (normal: 0.96–1.62 mmol/L)	1.42	0.51	0.55	0.76
Fibroblasts (normal: 2–4 g/L)	12.54	6.65	4.71	6.58
D-dimer (normal: 0–0.5 mg/L)	2.26	2.13	3.44	1.3
mNGS C. psittaci reads (n)	1255	1178	1563	3102
McMahon score	9	9.5	5	8

Abbreviations: AST, aspartate aminotransferase; BNP, brain natriuretic peptide; CK, creatine kinase; Cr, creatinine; CRP, C-reactive protein; LDH, lactate dehydrogenase; PCT, procalcitonin; WBC, white blood cell.

Figure 1 (A) Chest computed tomography (CT) of Case 1: consolidation in left lower lung and a small amount of pleural effusion on the left. (B) Chest CT of Case 2: large exudative consolidation foci in both lungs, mainly in the lower lobe, and a small amount of pleural effusion on both sides. (C) Chest CT of Case 3: consolidation in both lower lungs, mainly on the left and bilateral pleural effusion. (D) Chest CT of Case 4: right lung consolidation and ground-glass shadow.