Cases reported "Bordetella Infections"

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1/7. Cavitary pneumonia in an AIDS patient caused by an unusual bordetella bronchiseptica variant producing reduced amounts of pertactin and other major antigens.

    Although bordetella bronchiseptica can infect and colonize immunocompromised humans, its role as a primary pathogen in pneumonia and other respiratory processes affecting those patients remains controversial. A case of cavitary pneumonia caused by B. bronchiseptica in an AIDS patient is presented, and the basis of the seemingly enhanced pathogenic potential of this isolate (designated 814) is investigated. B. bronchiseptica was the only microorganism recovered from sputum, bronchoalveolar lavage fluid, and samples taken through the protected brush catheter. Unlike previous work reporting the involvement of B. bronchiseptica in cases of pneumonia, antibiotic treatment selected on the basis of in vitro antibacterial activity resulted in clearance of the infection and resolution of the pulmonary infiltrate. Although isolate 814 produced reduced amounts of several major antigens including at least one Bvg-activated factor (pertactin), the molecular basis of this deficiency was found to be BvgAS independent since the defect persisted after the bvgAS locus of isolate 814 was replaced with a wild-type bvgAS allele. Despite its prominent phenotype, isolate 814 displayed only a modest yet a significant deficiency in its ability to colonize the respiratory tracts of immunocompetent rats at an early time point. Interestingly, the antibody response elicited by isolate 814 in these animals was almost undetectable. We propose that isolate 814 may be more virulent in immunocompromised patients due, at least in part, to its innate ability to produce low amounts of immunogenic factors which may be required at only normal levels for the interaction of this pathogen with its immunocompetent natural hosts.
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2/7. bordetella bronchiseptica pneumonia and bacteremia following bone marrow transplantation.

    bordetella bronchiseptica is a frequent cause of respiratory infections in animals but rarely causes disease in humans. We describe a patient with B. bronchiseptica pneumonia and bacteremia that developed following bone marrow transplantation. B. bronchiseptica infection persisted despite antimicrobial therapy and may have progressed because of the combined effects of the patient's underlying immunosuppression and the antimicrobial antagonism between doxycycline and ciprofloxacin.
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3/7. bordetella bronchiseptica infection in pediatric lung transplant recipients.

    bordetella bronchiseptica are small, pleomorphic Gram-negative coccobacilli which are commensal organisms in the upper respiratory tract of many wild and domestic animals ('kennel cough' in dogs). While it is common for health care providers to ask about exposure to ill family/friends, most do not routinely inquire about the health or immunization status of household pets. We report two cases of B. bronchiseptica pneumonia in lung transplant recipients [cystic fibrosis (CF); ages 10 and 15 yr; one male] who contracted B. bronchiseptica from pet dogs. We compared their course and outcome to four children (two CF, one congenital heart disease and one Duchenne's muscular dystrophy; four males, age range 6 months to 14 yr) with B. bronchiseptica cultured from the respiratory tract. Two of the four patients also acquired their illnesses from pet dogs and two from unknown sources. One lung transplant recipient expired from progressive respiratory failure. We conclude that B. bronchiseptica can cause serious infections in both immunosuppressed and immunocompetent children. We speculate that a detailed history of exposure to ill pets (particularly dogs), and the immunization status of all pets should be included in the routine evaluation of all pediatric transplant recipients.
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4/7. Hospital-acquired bordetella bronchiseptica infection following hematopoietic stem cell transplantation.

    Two patients who had undergone nonmyeloablative allogeneic stem cell transplantation 53 and 112 days earlier and were being monitored at the same transplant center developed severe bordetella bronchiseptica infections within 3 days of each other. Pulsed-field gel electrophoresis analysis indicated that the isolates from the two cases were identical. Neither patient had had direct contact with animals since transplantation. These findings strongly support nosocomial transmission of B. bronchiseptica.
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5/7. bordetella bronchiseptica pneumonia in a patient with chronic lymphocytic leukemia.

    This case report describes two episodes of pneumonia caused by bordetella bronchiseptica in a patient with chronic lymphocytic leukemia. There was discrepancy between the in vitro sensitivity testing of the organism and subsequent clinical response to several antimicrobial agents. Human infection with B bronchiseptica is almost always associated with severe underlying disease and contact with an appropriate animal reservoir.
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6/7. Human bordetella bronchiseptica infection related to contact with infected animals: persistence of bacteria in host.

    Within a period of 2 1/2 years, bordetella bronchiseptica was isolated four times from a 79-year-old woman with bronchopneumonia. We have demonstrated by pulsed-field gel electrophoresis that this infection was related to contact with infected rabbits. The initial human B. bronchiseptica isolate had a phenotype characteristic of usual B. bronchiseptica clinical isolates; it produced toxin and adhesins, such as adenylate cyclase-hemolysin, filamentous hemagglutinin, and pertactin, and was able to induce lethality in a murine respiratory model. By contrast, although the three successive human isolates produced adhesins, they did not express adenylate cyclase-hemolysin and were unable to induce lethality. This implies that adenylate cyclase-hemolysin is required to induce lethality. We suggest that B. bronchiseptica may persist in the host, with expression of adenylate cyclase-hemolysin being essential for the initiation of infection and expression of adhesins being essential for persistence.
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7/7. Bordetella bronchoseptica pneumonia with shock in an immunocompetent patient.

    Bordetella bronchoseptica is a rarely reported cause of human infection, but is a common respiratory tract commensal of mammals. Human infection with B. bronchoseptica is almost always associated with severe underlying disease and contact with an appropriate animal reservoir. We report a case of pneumonia with shock caused by B. bronchoseptica in an immunocompetent patient.
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