Ornithosis (psittacosis) in children: causes, symptoms, diagnosis, treatment

Ornithosis (psittacosis) is an infectious disease caused by chlamydia and transmitted to humans from birds. Psittacosis is accompanied by symptoms of intoxication and lung damage.

ICD-10 code

A70 Infection caused by Chlamydia psittaci .

Epidemiology of ornithosis (psittacosis)

The natural reservoir of infection is wild and domestic birds, mainly ducks, pigeons, gulls, sparrows, parrots, in which the infection usually proceeds in latent latent form. Possible epizootics among birds. It is not excluded trans-ovarian transmission of the pathogen to the offspring of infected birds. Birds excrete the pathogen with feces and the secretion of the respiratory tract. The main transmission path is airborne and airborne dust. Infection of children occurs in contact with the rooms (parrots, canaries, bullfinches, etc.) and poultry (ducks, chickens, turkeys, etc.). In large cities, pigeons are especially dangerous, which contaminate faeces with balconies, cornices, window sills.

Among children, sporadic morbidity is usually recorded, but epidemic outbreaks are possible in organized children's groups if patients have decorative birds in the room.

The susceptibility to ornithosis is high, but the exact incidence is not established due to the difficulty of diagnosis.

Classification

There are typical and atypical forms of ornithosis (psittacosis). Typical cases include cases with lung damage, atypical - erased (by type of ARVI), subclinical (without clinical manifestations) form, as well as ornithic meningoencephalitis.

Typical ornithosis can be mild, moderate and severe.

The course of ornithosis can be acute (up to 1-1,5 months), prolonged (up to 3 months), chronic (more than 3 months).

Pathogenesis of ornithosis (psittacosis)

Infection penetrates through the respiratory tract. Propagation occurs in cells of the alveolar epithelium, epithelial cells of bronchioles, bronchi and trachea. The consequence may be the destruction of the affected cells, the release of the pathogen, its toxins and cellular decay products, which, entering the blood, cause toxemia, viralemia and sensitization. In severe cases, a hematogenous drift of the pathogen into the parenchymal organs, the central nervous system, the myocardium, etc. Is possible. In patients with impaired reactivity, the elimination of the pathogen is often delayed. It is in the cells of the reticuloendothelium, macrophages, epithelial cells of the respiratory tract for a long time. Under unfavorable conditions for microorganisms, the pathogen can enter the blood, which causes a relapse or worsening of the disease.

In the pathogenesis of ornithosis, secondary bacterial flora is important, so the process often proceeds as a mixed viral-bacterial infection.

Symptoms of ornithosis (psittacosis)

The incubation period of ornithosis (psittacosis) is from 5 to 30 days, on average - about 7-14 days. Ornithosis (psittacosis) begins acutely, with an increase in body temperature to 38-39 ° C, less often - up to 40 ° C, headaches and muscle pains, often chills. They note dry cough, sore throat, hyperemia of the mucous membranes, oropharynx, vascular injection of sclera and conjunctiva, flushing of the face, general weakness, insomnia, nausea, sometimes vomiting. Fever is mimicking or persistent. On the skin, sometimes there is a patchy-papular or rosaolous allergic rash. Changes in the lungs progressively increase. Initially, they detect tracheobronchitis. And from the 3-5th, less often from the 7th day of the disease, small-focal, segmental or draining pneumonia is formed mainly in the lower parts of the lungs.

In peripheral blood with uncomplicated ornithosis, leukopenia, aneosinophilia with lymphocytosis are noted; moderate increase in ESR.

Radiologic examination reveals inflammatory foci in the basal zone or central part of the lungs, on one or both sides.

Diagnosis of ornithosis (psittacosis)

It is possible to suspect ornithosis in a child if the disease developed after close contact with fallen or diseased birds and identified atypical pneumonia with a tendency to a prolonged torpid current.

For laboratory confirmation, the most important is the method of PCR and ELISA.

Treatment of ornithosis (psittacosis)

For the treatment of ornithosis (psittacosis) macrolides are used in the age-related dose for 5-10 days. At bacterial complications are shown cephalosporins, aminoglycosides. In severe cases of ornithosis, glucocorticoids are given a short course (up to 5-7 days). Widely used symptomatic, stimulating treatment and probiotics (acipol, etc.).

Prevention of ornithosis (psittacosis)

It is aimed at identifying ornithosis in birds, especially those with whom the person is in constant contact (economic and decorative). Quarantine measures are important in poultry farms affected by ornithosis, as well as veterinary supervision of imported poultry. In the system of preventive measures, it is crucial to educate the children of sanitary and hygienic skills when caring for decorative birds (pigeons, parrots, canaries). Ill ornithosis is subject to compulsory isolation until full recovery. Sputum and discharge of the patient is disinfected with 5% solution of lysol or chloramine for 3 hours or boiled in a 2% solution of sodium bicarbonate for 30 minutes. Specific prophylaxis is not developed.

[1], [2], [3], [4], [5]