Gestational psittacosis of the placenta with massive perivillous fibrin deposition leading to intrauterine fetal demise: A case report

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  • HATTORI Aoi
    Department of Obstetrics and Gynecology, Kansai Medical University
  • YOSHIDA Aya
    Department of Obstetrics and Gynecology, Kansai Medical University
  • OKU Kaede
    Department of Obstetrics and Gynecology, Kansai Medical University
  • KAMIYA Akio
    Department of Obstetrics and Gynecology, Kansai Medical University
  • KURODA Yumi
    Department of Obstetrics and Gynecology, Kansai Medical University
  • KASAMATSU Atsushi
    Nishikawa Ladies Clinic
  • OKADA Hidetaka
    Department of Obstetrics and Gynecology, Kansai Medical University

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  • Massive perivillous fibrin depositionを呈し，胎児死亡に至るも母体救命しえた妊娠オウム病の1症例

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<p> Psittacosis is a zoonotic disease from bird species caused by Chlamydia psittaci, which infects humans. The disease presents with various symptoms, including mild influenza-like illness, severe multiple organ dysfunction, and disseminated intravascular coagulation（DIC）. We present a case of gestational psittacosis of the placenta with massive perivillous fibrin deposition（MPFD）leading to intrauterine fetal demise at 17 weeks of gestation.</p><p> A 31-year-old pregnant woman（15 weeks of gestation, gravida 4, para 3）visited a clinic due to fever, headache, and cough. Two weeks later, she was admitted at a local hospital due to persistent fever and was then transferred to our hospital due to suspected meningitis. Physical examination demonstrated DIC caused by bacterial sepsis. Subsequently, she received intensive care, antibiotics, and anti-DIC treatment. On the second day, she was diagnosed with intrauterine fetal demise and the fetus was delivered by induction on the third day. On the same day, the mother was intubated due to pulmonary edema. Placental histopathologic examination revealed massive perivillous fibrin deposition. As a viral infection was suspected, we requested for further research by the National Institute of Infectious Diseases. They detected C. psittaci DNA only from the placental tissue. In conclusion, gestational psittacosis of the placenta caused maternal bacterial DIC, which resulted in placental dysfunction with MPFD and eventually fetal death. Heightened awareness for pregnant women to avoid contact with bird species should be observed. However, the extent of contact that can be critical remains unclear, and a future study is warranted to shed light on this.</p>

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