Hearing loss as the first symptom of pneumonia caused by Chlamydia psittaci: a case report and literature review

The typical clinical symptoms of psittacosis pneumonia include fever, dry cough, and chills. Sudden sensorineural hearing loss is a relatively uncommon condition in pneumonia caused by Chlamydia psittaci. In this study, we reported a rare case of Chlamydia psittaci pneumonia presented as hearing loss. A 65-year-old man presented to our hospital with sudden hearing loss, cough with sputum, and fever for the last three days. Chest computed tomography revealed inflammation of the left lung and poor response to broad-spectrum antibiotics. The metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid identified the sequence of Chlamydia psittaci. Subsequently, antibiotic treatment was adjusted to doxycycline hydrochloride and moxifloxacin, resulting in significant improvement in both hearing loss and lung infection. Sudden sensorineural hearing loss as an extrapulmonary feature of Chlamydia psittaci pneumonia is extremely rare. Although the exact mechanism remains unclear, this case report described a patient with sudden bilateral sensorineural hearing loss as a presenting feature of Chlamydia psittaci pneumonia, illustrating the importance of the extrapulmonary features of atypical pneumonia. The mNGS test could provide early diagnosis. Many patients had a good prognosis with prompt and effective treatment.