A possible association between Chlamydiae psittacci infection and temporalarteritis

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 psitta cci infection and a temporal arteritis. A 73-year-old woman, with no signif icant 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 intermit tent claudication of the jaws, clinical examination was poor. A biological inflammatory syndrome was noticed. Chest X-ray revealed bilateral interstit ial opacities. The titer of anti-C. posttaci antibodies was significant (po sitive lg G at 1/2048). Soon after initiation of doxycycline, a temporal ar teritis biopsy was performed, due to the persistence of clinical symptoms a nd high inflammatory syndrome, conclusive for the diagnosis of temporal art eritis. Corticotherapy was added to antibiotic therapy, resulting in the de crease 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 ant ibodies 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 seroep idemiological and molecular biology studies could allow us to clarify the a ssociation between Chlamydia infections and inflammatory vasculitis-like te mporal arteritis. (C) 2000 Editions scientifiques et medicales Elsevier SAS .