{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:04:49Z","timestamp":1789538689239,"version":"build-2803163510"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"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                    The coinfection of influenza A and\n                    <jats:italic>Chlamydia psittaci pneumoniae<\/jats:italic>\n                    is rarely described in China. However, the clinical features of these diseases pose a significant diagnostic challenge. Therefore, it is necessary to report and review such a potentially fatal case. We report an 89-year-old male patient requiring admission to the intensive care unit with acute hypoxemic respiratory failure, shock and MODS. He presented with fever, fatigue, anorexia and dyspnea. The patient exhibited severe hypoxemia, shock, hepatic dysfunction (elevated liver enzymes and serum bilirubin), acute kidney injury and a SOFA score of 17. Mechanical ventilation (MV) and venous-venous extracorporeal membrane oxygenation (VV-ECMO) were established for respiratory support. The initial diagnosis focused on\n                    <jats:italic>influenza A<\/jats:italic>\n                    for his positive\n                    <jats:italic>influenza A<\/jats:italic>\n                    nucleic acid. However, the patient's imaging presentation was not coupled with viral pneumonia, which raised suspicion for other pathogens. Metagenomic next-generation sequencing (mNGS) detected coinfection of\n                    <jats:italic>C psittaci<\/jats:italic>\n                    ,\n                    <jats:italic>influenza A H3N2<\/jats:italic>\n                    virus, and\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    in bronchoalveolar lavage fluid. Concurrent targeted NGS (tNGS) detected\n                    <jats:italic>C. psittaci<\/jats:italic>\n                    in blood. Omadacycline and baloxavir marboxil were prescribed. The patient's condition improved, and he was successfully weaned from VV-ECMO and MV. He was discharged and recovered on day 60 of the follow-up. This case underscores the diagnostic complexity of coinfection and the use of NGS testing in this severe condition and the role of omadacycline in\n                    <jats:italic>psittacosis<\/jats:italic>\n                    .\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1895006","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:32:00Z","timestamp":1789536720000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Coinfection of influenza A and Chlamydia psittaci pneumonia"],"prefix":"10.3389","volume":"13","author":[{"given":"Binbin","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueliang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenwei","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jincheng","family":"Ruan","sequence":"additional","affiliation":[{"name":"Department of Anus and Intestine Surgery, The TONGDE Hospital of Zhejiang Province","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2428411","DOI":"10.1080\/21505594.2024.2428411","article-title":"Chlamydia psittaci: a zoonotic pathogen causing avian chlamydiosis and 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