A possible association between Chlamydiae psittacci infection and temporal arteritis.
Some arguments are in favor of the role of Chlamydia in the pathogenesis of atherosclerosis and some vasculitis. Illustrating this possible relation, we report the case of a patient developing consecutively a Chlamydia psittacci infection and a temporal arteritis. A 73-year-old woman, with no significant medical history, was hospitalized for constitutional symptoms. Three weeks before, she had described fever and sore throat of two days' duration. Since that time, she had remained exhausted and developed a mild intermittent claudication of the jaws. Clinical examination was poor. A biological inflammatory syndrome was noticed. Chest X-ray revealed bilateral interstitial opacities. The titer of anti-C. psittaci antibodies was significant (positive 1g G at 1/2048). Soon after initiation of doxycycline, a temporal arteritis biopsy was performed, due to the persistence of clinical symptoms and high inflammatory syndrome, conclusive for the diagnosis of temporal arteritis. Corticotherapy was added to antibiotic therapy, resulting in the decrease of inflammatory syndrome and an improvement in the general status of the patient. X-ray opacities decreased in three weeks. Serological control after three months showed a decrease of the titer of anti-C. psittacci antibodies to 1/256, confirming the initial diagnosis of Chlamydia pneumopathy. Our observation could provide one more argument for the role of bacteria-like Chlamydia in the pathogenesis of vascular diseases. Prospective seroepidemiological and molecular biology studies could allow us to clarify the association between Chlamydia infections and inflammatory vasculitis-like temporal arteritis.
Bonnet
F
F
Service de médecine interne et maladies infectieuses, hopital Saint-André, Bordeaux, France. fabrice.bonnet@chu-aquitaine.fr
Morlat
P
P
Delevaux
I
I
Gavinet
A M
AM
Parrens
M
M
Bernard
N
N
Lacoste
D
D
Beylot
J
J
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000368:Aged; D002691:Chlamydophila psittaci; D018450:Disease Progression; D004318:Doxycycline / Q000008:administration & dosage; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D009956:Psittacosis / Q000150:complications*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D004318:Doxycycline