{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T05:25:46Z","timestamp":1766467546243,"version":"3.44.0"},"reference-count":24,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Faculty of Dental Medicine and Health Osijek"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Life"],"abstract":"<jats:p>Background: Nearly 10% of all community-acquired pneumonias are caused by Chlamydia pneumoniae. This is a Gram-negative intracellular coccus that poses a significant challenge for routine diagnostics due to its poor growth in tissue culture and non-specific clinical presentations. Case Report: This study presents the case of a 61-year-old man whose initial disease manifestation included a non-specific upper respiratory tract infection and reactive pericarditis. A diagnostic work-up of the etiology of pericarditis, with stepwise exclusion of other causative agents, led to confirmation of a possible chronic, recurrent C. pneumoniae infection, with good clinical and laboratory responses to azithromycin across multiple hospitalizations. However, upon initiation of prolonged doxycycline therapy, the disease course was complicated by the development of Guillain\u2013Barr\u00e9 syndrome. With appropriate treatment, the neurological deficit regressed, with near-complete resolution of the syndrome\u2019s clinical picture. Discussion and Conclusions: The development of reactive pericarditis and the patient\u2019s neurological symptoms stemmed from an immune response to bacterial antigens that resemble antigens of the central nervous system and the pericardium. Prolonged doxycycline therapy, together with symptomatic management of the neurological condition and concomitant pericarditis, represents good clinical practice and is one potential management approach for patients with similar presentations.<\/jats:p>","DOI":"10.3390\/life15101532","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T10:49:34Z","timestamp":1759142974000},"page":"1532","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Chlamydia Pneumoniae Pericarditis Complicated with Guillain\u2013Barr\u00e9 Syndrome"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-3102","authenticated-orcid":false,"given":"Vesna","family":"\u0106osi\u0107","sequence":"first","affiliation":[{"name":"Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"Polyclinic \u0106osi\u0107, 35000 Slavonski Brod, Croatia"},{"name":"General Hospital \u201cDr. Josip Ben\u010devi\u0107\u201d Slavonski Brod, 35000 Slavonski Brod, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9813-9008","authenticated-orcid":false,"given":"\u0110or\u0111e","family":"Pojati\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"Department of Internal Medicine, General County Hospital Vinkovci, 32100 Vinkovci, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iva","family":"Bakalar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, General County Hospital Vinkovci, 32100 Vinkovci, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1764-6966","authenticated-orcid":false,"given":"Nata\u0161a","family":"Moser","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"General Hospital \u201cDr. Josip Ben\u010devi\u0107\u201d Slavonski Brod, 35000 Slavonski Brod, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8868-6347","authenticated-orcid":false,"given":"Karla","family":"Mi\u0161ki\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"Dental Health Office \u201cDr. Karla Mi\u0161ki\u0107\u201d, 35000 Slavonski Brod, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6568-3306","authenticated-orcid":false,"given":"Bla\u017eenka","family":"Mi\u0161ki\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"General Hospital \u201cDr. Josip Ben\u010devi\u0107\u201d Slavonski Brod, 35000 Slavonski Brod, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1093\/eurheartj\/ehv318","article-title":"2015 ESC Guidelines for the Diagnosis and Management of Pericardial Diseases","volume":"36","author":"Adler","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"9342792","DOI":"10.1155\/2019\/9342792","article-title":"Long-Term Prognosis of Suspected Myocarditis and Cardiomyopathy Associated with Viral Infection of the Myocardial Tissue: A Meta-Analysis of Cohort Studies","volume":"2019","author":"Chen","year":"2019","journal-title":"Cardiovasc. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1001\/jama.2015.12763","article-title":"Evaluation and Treatment of Pericarditis: A Systematic Review","volume":"314","author":"Imazio","year":"2015","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.idc.2009.10.002","article-title":"Chlamydophila Pneumoniae","volume":"24","author":"Burillo","year":"2010","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1086\/315596","article-title":"Background and Current Knowledge of Chlamydia Pneumoniae and Atherosclerosis","volume":"3","author":"Grayston","year":"2000","journal-title":"J. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"260","DOI":"10.5539\/gjhs.v8n4p260","article-title":"Association of Chlamydia Pneumoniae Infection with Atherosclerotic Plaque Formation","volume":"8","author":"Assar","year":"2015","journal-title":"Glob. J. Health Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1177\/2047487312472078","article-title":"Chlamydia Pneumoniae and Progression of Subclinical Atherosclerosis","volume":"21","author":"Player","year":"2014","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1111\/j.1469-0691.1996.tb00586.x","article-title":"Chlamydia Pneumoniae and Cardiovascular Diseases","volume":"1","author":"Saikku","year":"1996","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1080\/20469047.2020.1728163","article-title":"Acute Haemorrhagic Pericarditis: An Unusual Presentation of Chlamydophila Pneumoniae Pneumonia Infection","volume":"40","author":"Fettah","year":"2020","journal-title":"Paediatr. Int. Child. Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.33425\/2639-846X.1014","article-title":"Acute Fulminant Chlamydia Pneumoniae Myocarditis Treated with Mechanical Circulatory Support in a Female Adult: A Case Report","volume":"2","author":"Zrna","year":"2018","journal-title":"Anesth. Pain. Res."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"De Meyst, A., Alexiou, Z., Lernout, T., Morr\u00e9, S.A., and Vanrompay, D. (2024). Challenges in Chlamydial Serology: Insights from a Belgian and a Dutch Population Cohort. Microorganisms, 12.","DOI":"10.3390\/microorganisms12040658"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Gnarpe, H.G., and Gnarpe, J. (2005). Chlamydia Pneumoniae and Myocarditis. Infectious Agents and Pathogenesis, Springer.","DOI":"10.1007\/0-306-48741-1_13"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1680","DOI":"10.1212\/WNL.0b013e3181e07d14","article-title":"Distinguishing Acute-Onset CIDP from Fluctuating Guillain-Barr\u00e9 Syndrome","volume":"74","author":"Ruts","year":"2010","journal-title":"Neurology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1001\/archneur.1994.00540190051014","article-title":"Further Regional Variants of Acute Immune Polyneuropathy","volume":"51","author":"Ropper","year":"1994","journal-title":"Arch. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1056\/NEJM199204233261706","article-title":"The Guillain-Barr\u00e9 Syndrome","volume":"326","author":"Ropper","year":"1992","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3075","DOI":"10.1093\/eurheartj\/ehv319","article-title":"2015 ESC Guidelines for the Management of Infective Endocarditis","volume":"36","author":"Habib","year":"2015","journal-title":"Eur Heart J"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/j.1469-0691.2006.01393.x","article-title":"The Atypical Pneumonias: Clinical Diagnosis and Importance","volume":"12","author":"Cunha","year":"2006","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"580","DOI":"10.3855\/jidc.1704","article-title":"Acute and Chronic Chlamydia Pneumoniae Infection and Inflammatory Markers in Coronary Artery Disease Patients","volume":"5","author":"Haider","year":"2011","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1097\/01.mat.0000169077.53643.97","article-title":"Early Detection and Successful Therapy of Fulminant Chlamydia Pneumoniae Myocarditis","volume":"51","author":"Hoefer","year":"2005","journal-title":"ASAIO J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1126\/science.283.5406.1335","article-title":"Chlamydia Infections and Heart Disease Linked through Antigenic Mimicry","volume":"283","author":"Bachmaier","year":"1999","journal-title":"Science"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1007\/s00296-022-05106-3","article-title":"Concurrent Myopathy and Inflammatory Cardiac Disease in COVID-19 Patients: A Case Series and Literature Review","volume":"42","author":"Freund","year":"2022","journal-title":"Rheumatol. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1385\/NCC:1:4:461","article-title":"Unilateral Third Nerve Palsy Caused by Guillain-Barr\u00e9 Syndrome","volume":"1","author":"Jacobson","year":"2004","journal-title":"Neurocrit Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"459","DOI":"10.3855\/jidc.1508","article-title":"The Presence of Mycoplasma Pneumoniae Infection and GM1 Ganglioside Antibodies in Guillain-Barr\u00e9 Syndrome","volume":"5","author":"Sharma","year":"2011","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_24","first-page":"CD002063","article-title":"Intravenous Immunoglobulin for Guillain-Barr\u00e9 SyndromE","volume":"2014","author":"Rac","year":"2014","journal-title":"Cochrane Libr."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/10\/1532\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T11:24:14Z","timestamp":1759145054000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/10\/1532"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,29]]},"references-count":24,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["life15101532"],"URL":"https:\/\/doi.org\/10.3390\/life15101532","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,29]]}}}