Abstract
Introduction
The Japanese Respiratory Society (JRS) atypical pneumonia score is a useful tool for
the rapid presumptive diagnosis of atypical pneumonia. We investigated the clinical
features of community-acquired pneumonia (CAP) due to Chlamydia psittaci and validated the JRS atypical pneumonia score in patients with C. psittaci CAP.
Methods
This study was conducted at 30 institutions and assessed a total of 72 sporadic cases
with C. psittaci CAP, 412 cases with Mycoplasma pneumoniae CAP, and 576 cases with Streptococcus pneumoniae CAP.
Results
Sixty-two of 72 patients with C. psittaci CAP had a history of avian exposure. Among the six parameters of the JRS score, matching
rates of four parameters were significantly lower in the C. psittaci CAP than the M. pneumoniae CAP in the following parameters: age <60 years, no or minor comorbid illness, stubborn
or paroxysmal cough, and absence of chest adventitious sounds. The sensitivity of
the diagnosis of atypical pneumonia in patients with C. psittaci CAP was significantly lower than the M. pneumoniae CAP (65.3% and 87.4%, p < 0.0001). When the diagnostic sensitivity was analyzed for
different ages, the diagnostic sensitivities for the C. psittaci CAP were 90.5% for non-elderly patients and 30.0% for elderly patients.
Conclusions
The JRS atypical pneumonia score is a useful tool for distinguishing between C. psittaci CAP and bacterial CAP in patients aged <60 years, but not in patients aged ≥60 years.
A history of avian exposure in middle-aged patients with normal white blood cell count
may be suggestive of C. psittaci pneumonia.
Keywords
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Article info
Publication history
Published online: May 19, 2023
Accepted:
May 10,
2023
Received in revised form:
March 25,
2023
Received:
February 14,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
