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Psittacosis with a reversed halo sign
* For correspondence: yhaba@juntendo.ac.jp
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Received: ,
This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
A 26 yr old woman† presented to the emergency room of Juntendo University Hospital, Tokyo, Japan, in June 2016 with a two-week history of cough and fever after coming into contact with pigeon faeces. She was admitted and serologically diagnosed with psittacosis. Chest radiography revealed a uniform infiltrative shadowing in the left upper lung field (Fig. 1), and chest computed tomography (CT) revealed a bronchial wall thickening, air-space consolidation and a reversed halo sign, characterized by a denser uniform shadow surrounding the central ground-glass opacity in the periphery of the left upper lobe (Fig. 2). Symptoms promptly improved with three days of oral azithromycin (500 mg/day). Radiography performed 26 days after onset showed no pneumonia, but a mild cough persisted for two months.
- Chest radiograph showing a uniform infiltrative opacity in the left upper lung field (arrows).
- Axial chest computed tomography showing a reversed halo sign along with bronchodilation, bronchial wall thickening, nodular shadowing and air-space consolidation (arrows).
A reversed halo sign on CT is seen in many diseases. The pneumonia lesion of Chlamydia psittaci due to the intense immune reaction spreads non-segmentally through Kohn pores, but the older, central part of the lesion heals quickly. The present picture may represent one of the transient images of the pneumonia.
