A 16-year-old female was admitted to another hospital with complaints of fever, non-productive cough and dyspnea. Despite treatment with β-lactam antibiotics, the patient's arterial blood gas analysis revealed severe hypoxemia, following which the patient was brought to our emergency department. On admission to our hospital, the arterial partial pressure of oxygen under the condition of 10
l/min. O
2 inhalation was 48mmHg, and a chest roentgenogram revealed bilateral wide-spread infiltrative opacities. Under the diagnosis of atypical pneumonia associated with acute respiratory distress syndrome (ARDS), we started treatment with administration of minocycline, erythromycin and corticosteroids, mechanical ventilation and continuous hemodiafiltration. Consequently, the chest roentgenogram and hypoxemia gradually improved, and mechanical ventilation was discontinued on five day after admission. The serum titer of a complement fixation test against
Chlamydia on the day of admission was revealed as 1:128 on day 8 post admission. In addition, on interviewing the patient, we discovered that doves had made a nest on the veranda of the patient's house. Therefore we made a final diagnosis of psittacosis associated with ARDS. Psittacosis should be considered as a possible cause of ARDS necessitating intensive care including mechanical ventilation.
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