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Case Reports
. 2022 Oct 12;9(10):ofac524.
doi: 10.1093/ofid/ofac524. eCollection 2022 Oct.

A Case Study of Zoonotic Chlamydia abortus Infection: Diagnostic Challenges From Clinical and Microbiological Perspectives

Anne-Valérie Burgener  1 , Helena M B Seth-Smith  2   3 , Sina Kern-Baumann  4 , Ana Durovic  1 , Anette Blaich  2 , Thomas Menter  5 , Elisabeth Bruder  5 , Tim Roloff  2   3 , Aurélien Martinez  1 , Nicole Borel  6 , Sarah Albini  7 , Irene Hösli  4 , Adrian Egli  2   3 , Maja Weisser  1 , Vladimira Hinić  2
Affiliations
Case Reports

A Case Study of Zoonotic Chlamydia abortus Infection: Diagnostic Challenges From Clinical and Microbiological Perspectives

Anne-Valérie Burgener et al. Open Forum Infect Dis. .

Abstract

Chlamydia abortus is the most common causative agent of abortion in small ruminants, but it is poorly recognized as a human pathogen. In most published case studies, diagnosis remained difficult and often resulted in delayed initiation of therapy. In this case study of severe C abortus infection in a pregnant farmer from Switzerland, we highlight the clinical and microbiological diagnostic challenges and provide evidence of a zoonotic epidemiological link.

Keywords: Chlamydia abortus; abortion; doxycycline; pregnancy; sequencing; zoonosis.

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Conflict of interest statement

Potential conflicts of interest. The authors: No reported conflicts of interest.

Figures

Figure 1.
Figure 1.
Histological findings of the placenta. A, Overview of a basally accentuated inflammatory infiltrate with perivillous fibrin deposits (hematoxylin and eosin [H&E] staining, ×20). B, Higher resolution of the basal placenta showing abscessing inflammation of the decidua and infarction of the adjacent placental parenchyma (H&E staining, ×100). C, Higher resolution of the placental parenchyma showing florid intervillositis with necrosis of the syncytiotrophoblastic layer of the villi and perivillous fibrin deposition (H&E staining, ×400).
Figure 2.
Figure 2.
Cross-reactivity with Chlamydia psittaci by microimmunofluorescence assay. Time point 1: test performed upon hospital admission; immunoglobulin M (IgM) and immunoglobulin G (IgG) negative. Time point 2: 4 days after intrauterine fetal death (and 12 days after initial symptoms); IgM not interpretable due to presence of unspecific fluorescence, IgG positive. Positive specific fluorescence: presence of granular fluorescence in the cytoplasm and between the cells (eg, positive control). Unspecific fluorescence: differentiation between unspecific and specific fluorescence by comparison of fluorescence of infected cells to uninfected cells (nonspecific binding control).
Figure 3.
Figure 3.
Schematic representation of the clinical course. Diagnoses and antibiotic therapies are indicated. Doses of antibiotic therapies: ceftriaxone, 1 × 2 g/d intravenous (IV), meropenem 3 × 2 g/d IV, trimethoprim-sulfonamide 2 × 240/1200 mg/d oral, ciprofloxacin 2 × 500 mg/d IV, doxycycline 2 × 100 mg/d oral. Red line represents course of temperature in degrees Celsius. Black line represents days. Abbreviations: ARDS, acute respiratory distress syndrome; ICU, intensive care unit; IUFD, intrauterine fetal death; T, temperature; Tc-penia, thrombocytopenia; TMP-SMX,trimethoprim/sulfamethoxazole.
See this image and copyright information in PMC

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