Internal Medicine

0521779407-17 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:19

1234 Pseudomonas Infections Psittacosis

■Bone and Joint Infections – osteomyelitis 6–8 weeks; septic arthritis

3–4 weeks with joint drainage; osteochondritis 2 weeks with debride-

ment

■Ear Infections – otitis externa treated with antibiotic drops; basi-

lar skull osteomyelitis 6–8 weeks with limited surgery to debride

necrotic tissue and drain abscesses

■Eye Infections – topical aminoglycosides, subconjunctival or sub-

Tenon antibiotic injections and intravenous antibiotics depending

upon severity of disease

■Skin Infections – hot tub dermatitis resolves without therapy; other

skin infections 10–14 days

■Meningitis – 2–3 weeks

■Endocarditis – 6–8 weeks plus surgery, as indicated

follow-up

■Resolution of infection may be slow, especially in the immunocom-

promised patient.

■Routine follow-up required

complications and prognosis

■Variable; depends on organ system involved and immune status of

host; acute, fulminant infections associated with high mortality

PSITTACOSIS

RICHARD A. JACOBS, MD, PhD

history & physical

History

■Causative agentChlamydia psittaci, an obligate intracellular bacte-

ria

■Major reservoir is birds (any species can be infected, not just

psitticines); rarely other animals (cattle, sheep, goats) can transmit

disease; infected birds may be asymptomatic or ill, with ill birds

excreting more organisms in their feces, urine and beaks than well

birds

■Anyone with exposure to birds is at increased risk of infection, includ-

ing bird owners, importers of birds, chicken and turkey farmers, vet-

erinarians, abattoir and processing plant workers.

■Humans infected by inhalation of aerosolized organisms; person-

to-person transmission rare