A hacking cough is a prominent feature that may appear at the outset or after several days of fever and malaise. Initially, the cough is nonproductive, but later, a small amount of mucoid or, occasionally, blood-streaked sputum may be produced. Headache is conspicuous in the majority of patients. Mild sore throat and cervical adenitis are occasionally seen as early symptoms. A relative bradycardia is often present.
Pleural effusion is rare.
Splenomegaly occurs in about 10 percent of patients, and its occurrence in a patient with pneumonia suggests the diagnosis of psittacosis. Focal noncaseating granulomas have been found on liver biopsy. The clinical course is variable. Myocarditis and pericarditis are rare complications of pulmonary psittacosis. C. psittaci is a rare cause of culture-negative endocarditis.