[ Chlamydia psittaci pneumonia complicated with rhabdomyolysis: a case report and literature review].

Objective: To analyze the clinical characteristics and the diagnosis and treatment of Chlamydia psittaci pneumonia complicated with rhabdomyolysis. Methods: We reported a case of Chlamydia psittaci pneumonia complicated with rhabdomyolysis. We did a literature review on the published reports between January 1978 and May 2020 by searching with the key words of "psittacosis" or " Chlamydia psittac i" and "rhabdomyolysis" in the PubMed database (time frame: January 1, 1967 to May 30, 2020). Results: Our patient was a 64-year-old male presenting with high-grade fever, fatigue, myalgia and dyspnea. A computed tomographic scan of the chest revealed bilateral pneumonia, which was further complicated with rhabdomyolysis during disease progression. This prompted the metagenomic next-generation sequencing, revealing the sequences of Chlamydia psittaci in both the bronchoalveolar lavage fluid and blood. Of the 11 cases in the 3 literature reports that we retrieved, 5 had concomitant rhabdomyolysis (two of which did not have complete clinical information), and the other 6 cases had myositis complicated with an elevated level of creatine phosphokinase. This yielded 3 cases with complete clinical information for our analysis. We had further incorporated their information with the single case managed within our study site. Two were males and the other 2 were females. The patients were aged 66, 46, 44 and 64 years, respectively. All cases had fever and 3 had a contact history with live poultry. Two cases had myalgia and progressed rapidly into having respiratory failure, and the other 2 cases did not develop myalgia and improved significantly after a timely treatment. All 4 cases were cured and discharged after treatment with appropriate antibiotics. No adverse outcomes were observed. Conclusions: The prognosis of Chlamydia psittaci pneumonia complicated with rhabdomyolysis was poor in case of a delayed treatment. Early diagnosis would help reduce the mortality.