{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:26:25Z","timestamp":1771921585292,"version":"3.50.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    <jats:italic>Chlamydia psittaci<\/jats:italic>\n                    is a known cause of severe pneumonia and may be associated with invasive fungal co-infections; however, its complication by\n                    <jats:italic>Aspergillus terreus<\/jats:italic>\n                    is exceptionally rare. We report a case of a previously healthy 58-year-old woman with poultry exposure who presented with fever and dyspnea that rapidly progressed to respiratory failure requiring mechanical ventilation. After initial empirical antibiotics failed, targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid concurrently identified\n                    <jats:italic>Chlamydia psittaci<\/jats:italic>\n                    and\n                    <jats:italic>Aspergillus terreus<\/jats:italic>\n                    , guiding successful targeted therapy with doxycycline and voriconazole, which led to full recovery. This case highlights the utility of tNGS in enabling rapid, simultaneous pathogen identification and guiding targeted therapy in severe pneumonia.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1750879","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T06:46:54Z","timestamp":1771915614000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe pneumonia caused by Chlamydia psittaci and Aspergillus terreus: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Chuanli","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Nanjing Jiangbei Hospital","place":["Nanjing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Nanjing Jiangbei Hospital","place":["Nanjing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"101197","DOI":"10.1016\/j.lanmic.2025.101197","article-title":"Zoonotic infections due to avian Chlamydia Abortus: what are we missing?","volume":"6","author":"Borel","year":"2025","journal-title":"Lancet Microbe"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e62","DOI":"10.1016\/s2666-5247(22)00306-8","article-title":"Chlamydia Psittaci should be a notifiable infectious disease everywhere","volume":"4","author":"Liu","year":"2023","journal-title":"Lancet Microbe"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s13052-023-01497-6","article-title":"A pediatric case of Chlamydia Psittaci caused severe acute respiratory distress syndrome (Ards) in Italy","volume":"49","author":"Marchese","year":"2023","journal-title":"Ital J Pediatr"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1157540","DOI":"10.3389\/fcimb.2023.1157540","article-title":"Clinical identification and microbiota analysis of Chlamydia Psittaci- and Chlamydia Abortus- pneumonia by metagenomic next-generation sequencing","volume":"13","author":"Xie","year":"2023","journal-title":"Front Cell Infect Microbiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.3390\/microorganisms13061218","article-title":"Exploring factors driving the uneven distribution of aspergillus Terreus in an Austrian hotspot region","volume":"13","author":"Schobert","year":"2025","journal-title":"Microorganisms"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"539","DOI":"10.3390\/microorganisms9030539","article-title":"The environmental spread of aspergillus Terreus in Tyrol, Austria","volume":"9","author":"Dietl","year":"2021","journal-title":"Microorganisms"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1093\/cid\/ciw326","article-title":"Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America","volume":"63","author":"Patterson","year":"2016","journal-title":"Clin Infect Dis"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"5523","DOI":"10.2147\/idr.S482471","article-title":"Psittacosis pneumonia features, distinguishing characteristics, and outcomes: a retrospective study","volume":"17","author":"Lu","year":"2024","journal-title":"Infection Drug Resistance"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e0047725","DOI":"10.1128\/spectrum.00477-25","article-title":"Clinical characteristics and risk factors associated with severe community-acquired pneumonia infected by Chlamydia Psittaci","volume":"13","author":"Xu","year":"2025","journal-title":"Microbiol Spectrum"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1186\/s12879-025-11450-z","article-title":"Clinical characteristics of Chlamydia Psittaci pneumonia: a single-center, retrospective study over 5 years","volume":"25","author":"Zhu","year":"2025","journal-title":"BMC Infect Dis"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.3390\/pathogens12091165","article-title":"Psittacosis: an underappreciated and often undiagnosed disease","volume":"12","author":"Dembek","year":"2023","journal-title":"Pathogens"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1552236","DOI":"10.3389\/fcimb.2025.1552236","article-title":"The significance of metagenomic next-generation sequencing and targeted next-generation sequencing in the diagnostic evaluation of patients with suspected pulmonary infections","volume":"15","author":"Tang","year":"2025","journal-title":"Front Cell Infect Microbiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1728","DOI":"10.1161\/circresaha.121.319077","article-title":"Interleukin-6 signaling and anti-Interleukin-6 therapeutics in cardiovascular disease","volume":"128","author":"Ridker","year":"2021","journal-title":"Circ Res"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1016\/j.ijmm.2011.04.011","article-title":"Interaction of the mucosal barrier with accessory immune cells during fungal infection","volume":"301","author":"Weindl","year":"2011","journal-title":"Int J Medical Microbiol: IJMM"}],"container-title":["Frontiers in 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