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Chest Infections |

Bordetella bronchiseptica (aka, “Kennel Cough”): Pathogen or Colonization? FREE TO VIEW

Brian Reichardt, MD; David Stoeckel, MD
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Saint Louis University, Saint Louis, MO


Chest. 2014;146(4_MeetingAbstracts):149A. doi:10.1378/chest.1994351
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Abstract

SESSION TITLE: Infectious Disease Global Case Reports

SESSION TYPE: Global Case Report

PRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PM

INTRODUCTION: Bordetella bronchiseptica is a common pathogen in animals, but has infrequently been implicated in human infections. We report a case of culture positive Bordetella bronchiseptica in a patient with interstitial lung disease.

CASE PRESENTATION: A 44 year-old woman with asthma and seasonal allergic rhinitis presented with a six month history of dyspnea on exertion. She had already been treated with inhaled corticosteroids, an oral prednisone taper, and two separate courses of antibiotics including a macrolide. A CT scan of the chest showed bibasilar interstitial opacities. Bronchoscopic examination revealed hyperemic mucosa with moderate clear , foamy secretions. Interestingly, lung tissue culture and bronchial washings grew Bordetella bronchiseptica. She was treated with a 10 day course of ciprofloxacin. Occupational history noted upon follow-up was significant for prior work experience at an animal shelter. As recently as one year prior to presentation, she was involved in the cleaning of animal cages. Despite fluoroquinolone treatment, our patient remained symptomatic and pulmonary function testing revealed moderate restriction and severely decreased DLCO. Surgical lung biopsy revealed fibrotic non-specific interstitial pneumonitis.

DISCUSSION: Bordetella bronchiseptica is best characterized as a small gram-negative coccobacillus that is catalase, oxidase, and beta-lactamase positive. It inhabits the respiratory tracts of canines, causing “kennel cough” and pneumonitis. 1 The case we describe represents the second known case of Bordetella bronchiseptica in a patient with biopsy-documented interstitial lung disease.2 The vast majority of culture-confirmed cases have been reported in immuno-compromised individuals. Of these cases, manifestations have ranged from asymptomatic colonization and bronchitis to cavitary pneumonia and fatal respiratory failure.3

CONCLUSIONS: In our case, as in many cases, it is unclear whether the organism recovered from bronchial washings and tissue biopsy represents a true pathogen or an opportunistic colonizer. Given our patient’s persistent symptoms following treatment with a fluoroquinolone, one may infer that her symptoms were secondary to her underlying ILD, and not an acute infection with Bordetella bronchiseptica. However, given how infrequently Bordetella bronchiseptica is isolated from the human respiratory tract, we are uncertain as to this organism’s relationship with ILD and how it may affect disease progression and treatment.

Reference #1: {C}Woolfrey BF, Moody JA. Human infections associated with Bordetella bronchiseptica. Clin Microbiol Rev. 1991 Jul;4(3):243-55. Review. PubMed PMID: 1889042; PubMed Central PMCID: PMC358197.

Reference #2: Papasian CJ, Downs NJ, Talley RL, Romberger DJ, Hodges GR. Bordetella bronchiseptica bronchitis. J Clin Microbiol. 1987 Mar;25(3):575-7. PubMed PMID: 3571462; PubMed Central PMCID: PMC265999.

Reference #3: Berkowitz DM, Bechara RI, Wolfenden LL. An unusual cause of cough and dyspnea in an immunocompromised patient. Chest. 2007 May;131(5):1599-602. PubMed PMID: 17494814.

DISCLOSURE: The following authors have nothing to disclose: Brian Reichardt, David Stoeckel

No Product/Research Disclosure Information


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