Hearing loss as the initial manifestation of Chlamydia psittaci pneumonia in an older adult: A case report and literature review.

Chlamydia psittaci (C. psittaci) pneumonia is a zoonotic infection that typically presents with fever, cough, and fatigue. Sudden sensorineural hearing loss is an uncommon manifestation and may lead to early misdiagnosis. We report a 67-year-old woman admitted with fever for 1 week and hearing loss for 3 days. Chest computed tomography revealed extensive consolidation in the right lung, and empirical anti-infective therapy was ineffective. Targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid (BALF) detected C. psittaci. Following confirmation of the diagnosis, antimicrobial therapy was switched to minocycline. The patient's temperature normalized, hearing improved significantly, pulmonary lesions regressed, and follow-up chest imaging showed near-complete absorption of infiltrates. This case indicates that C. psittaci pneumonia can initially present with hearing loss. Careful evaluation of avian exposure history, characteristic imaging findings, and early molecular pathogen testing may facilitate timely diagnosis and tetracycline-based targeted treatment.