ABSTRACT
The authors present the case of a 32 years male patient admitted for lung consolidations with bilateral extension tendency, associated to fever, respiratory failure and hepatic involvement, with a sudden onset two weeks after contact with apparently healthy parrots. Bronchiolo-alveolar lavage was suggestive for a hypersensitivity pneumonia, but the clinical evolution was good with antibiotics (macrolides, than doxycycline). Radiologic resolution was spectacular. Serum antibodies anti-ch. Psittaci were present in low titre, at the limit of significance. Final diagnosis was chlamydia psittaci pneumonia.
Subject(s)
Bird Diseases/transmission , Parrots , Pneumonia, Bacterial/diagnosis , Psittacosis/diagnosis , Adult , Animals , Anti-Bacterial Agents/therapeutic use , Chlamydophila psittaci/isolation & purification , Diagnosis, Differential , Humans , Male , Pneumonia, Bacterial/drug therapy , Pneumonia, Bacterial/transmission , Psittacosis/drug therapy , Psittacosis/transmission , Serologic Tests/methods , Treatment OutcomeABSTRACT
AIM: evaluation of real ambulatory treatment followed by COPD patients. Eighty COPD patients were prospectively interviewed: 1 in stage I, 11 in stage II, 36 in stage III and 32 in stage IV. They were asked what medication they use as chronic ambulatory treatment and on what duration through one year, how many periodic check-ups they make. Most used medication is: short acting beta-2-agonists (63 pts), inhaled corticosteroids (40 pts), aminophylline (37 pts), long-acting theophylline (36 pts), and fixed combinations steroid + long-acting beta-2-agonist (35 pts). Eighteen patients had chronic prednisone treatment and 12 antibiotic prophylactic treatment. Only 31 patients had an anti-flu vaccine. There are no significant differences between treatment in rural and urban patients. Most patients follow the treatment for only 6 months a year. CONCLUSIONS: real ambulatory treatment in COPD is generally insufficient as duration and therapeutic principles, associating low frequency of periodic check-ups and a high frequency of exacerbations.