Diagnosis of psittacosis

Recognition of psittacosis is only possible when taking into account the epidemiological data (contact with birds), the characteristic clinical symptoms, confirming radiologic data, and the results of laboratory research. When hardly proceeding disease identified four clinical-radiological type of pneumonia: interstitial, small, krupnooptovye and lobes. Characterized by the extension of roots and increased bronchial and vascular pattern, and in some cases and increase the bifurcation of the lymph nodes. When the chronic psittacosis and clinically significant residual phenomena radiograph shows a picture of chronic bronchitis, the pneumosclerosis and chronic pneumonia.
Blood in viral pneumonia is marked leukopenia, in viral-bacterial - leukocytosis. In the period reverse the disease - lymphocytosis. ROHE, except erased and mild forms, faster, sometimes significantly (50 - 70 mm per hour). Rapid and specific diagnostic method is the formulation of an allergic diagnostic (intradermal) samples with chlamydia psittaci allergen with 2-5-th day of illness. Allergen (fabric diagnostikum) and monitoring is entered separately in the forearm intradermally 0.1 ml Pre-skin treated with alcohol. In case of a positive result, redness and infiltration. Reaction appreciate in 24-36 - 48 hours. By hyperemia and infiltrate the size is 0,5X0,5cm test is assessed by one cross (+), 1,0X1,0 cm - two (+ + ), 2,0X2,0 cm - three crosses (+ + + ). Hyperemia and infiltrate usually disappear after 36-48 hours, but sometimes it is long kept, and even leave brown pigmentation. Allergic test positive in 97.5%; gives a positive reaction I had been ill, and after 2 to 3 years, and in the chronic form, psittacosis 3-5 and more years. For serodiagnosis apply reaction of binding complement (RAC) with serum of the patient and chlamydia psittaci antigen, which is positive since the end of the first - beginning of the second week of the disease with increasing titers from negative to 1 : 64-1 : 128. Diagnostic titre is 1 : 16, but it is important increase its dynamics. Positive reaction is we recover after 1 - 2 years in patients with residual effects and suffering from a chronic form of psittacosis Most reliable method - detection of the pathogen from the blood during the first days, and from sputum up to 15-20 th day of illness. Virus isolation of the authorities and the blood of the slaughtered or dead birds can serve as indirect confirmation of the disease in working farms.
Differential diagnosis psittacosis should be carried out with the flu (see), adenovirus infections (see), pneumonia (see), typhoid fever (see) and typhus (see), and q-fever (see), tularemia (see), infectious mononucleosis (see) and pulmonary TB (see).

Complications. In some cases it is possible accession of myocarditis, tromboflebitov. Possible paralyzed vocal cords, polyneuritis, encephalomyelitis, pleurisy, cornification lung collapse.
The diagnosis. Recognition of ornithosis possible, taking into account the results of clinical and laboratory examinations, epidemiological history (contact with birds). Appropriate formulation of skin Allergy testing. Specific antigen and control is administered separately strictly intradermally 0.1 ml in the skin of the forearm. In the positive cases appear redness and infiltration. Reaction appreciate after 18-24 hours. If there infiltrate 0.5 X 1 cm sample is estimated by two crosses, 1X2 cm - three, 2X3 cm - four crosses. In some cases, the test may be positive in patients with brucellosis epidemic hepatitis and other Blood for isolation of the causative agent take in quantity 7-10 ml in the first two weeks of illness and prior antibiotic treatment. For serological studies (RAC) blood is taken in the first days and a month later, from the onset. For isolation of the causative agent explore nasal discharge, received by wiping the back of the throat with a cotton swab or throat rinsing physiological solution. Sputum is collected in the Bank. A positive test is not later than the 26th day of illness. All objects, except the blood sent to the laboratory in a frozen state or in ice.