Chlamydia Abortus-Induced Pneumonia with Psychiatric Symptoms and Pneumomediastinum: A Case Report

Bing Ding,* Zengkai Xu,* Youtang Li, Zhiyi Ma Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhiyi Ma, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Longyan, Fujian, 364000, People’s Republic of China, Email [email protected]: Chlamydia abortus is a zoonotic pathogen that commonly causes abortion, pelvic inflammatory disease, or septicemia during pregnancy in humans. It can occasionally lead to pneumonia.Case Presentation: We report a 35-year-old male with pneumonia complicated by psychiatric symptoms and pneumomediastinum. Initial treatment with cefotaxime and piperacillin-tazobactam failed. On admission, chest CT revealed bilateral pulmonary inflammation, pneumomediastinum, and cervical subcutaneous emphysema. Bronchoalveolar lavage fluid underwent Targeted Next-Generation Sequencing, identifying Chlamydia abortus. Treatment with doxycycline and moxifloxacin led to resolution of fever, psychiatric symptoms, and pulmonary lesions. The patient continued oral doxycycline post-discharge, and follow-up CT showed near-complete recovery.Conclusion: Chlamydia abortus infection can cause pneumonia with psychiatric symptoms, pneumomediastinum, and cervical emphysema—complications not previously reported. Targeted Next-Generation Sequencing (Targeted NGS) plays a crucial role in the early and precise detection of Chlamydia abortus, improving diagnostic accuracy and treatment timeliness. Doxycycline is effective in the treatment of Chlamydia abortus infection and contributed to the patient’s recovery.Keywords: Chlamydia abortus, pneumonia, psychiatric symptoms, pneumomediastinum, next-generation sequencing, case report