Lower respiratory tract infection caused by Chlamydia psittaci and Mycobacterium tuberculosis complex: coinfection or succession of events?

Abstract

Numerous microorganisms can cause lower respiratory tract infections, including strict pathogens such as Chlamydia psittaci and Mycobacterium tuberculosis complex (MTBC). C. psittaci is a zoonotic agent with a wide range of hosts, mainly birds. Humans who are sick or infected in the latent phase are the reservoir of MTBC. Both are intracellular microorganisms with complex physio-pathogenesis and airborne transmission. A case of infection with C. psittaci and MTBC in an immunocompetent woman with no obvious epidemiological link is presented. Both microorganisms were detected in bronchoalveolar lavage sample using real-time polymerase chain reaction (rt-PCR) techniques. No resistance-associated mutations to isoniazid or rifampicin were detected in CMTB and it was also recovered in culture. The patient was treated with doxycycline for C. psittaci and with isoniazid, pyrazinamide, rifampicin and ethambutol for MTBC with therapeutic success.