Pneumonia caused by Bordetella bronchiseptica in two HIV-positive patients

ABSTRACT: CONTEXT AND OBJECTIVE: Bordetella bronchiseptica (BB) is a Gram-negative coccobacillus responsible for respiratory diseases in dogs, cats and rabbits. Reports on its development in humans are rare. However, in immunosuppressed patients, especially in those with the immunodeficiency virus (HIV), BB can cause severe pulmonary infections. We report on two cases of pneumonia caused by BB in HIV-positive male patients in a university hospital. CASE REPORT: The first case comprised a 43-year-old patient who was admitted presenting chronic leg pain and coughing, with suspected pneumonia. BB was isolated from sputum culture and was successfully treated with trimethoprim/sulfamethoxazole in association with levofloxacin. The second case comprised a 49-year-old patient who was admitted presenting fever, nausea, sweating and a dry cough, also with suspected pneumonia. BB was isolated from sputum culture, tracheal secretions and bronchoalveolar lavage. The disease was treated with ciprofloxacin but the patient died. CONCLUSION: BB should be included in the etiology of pneumonia in immunodeficient HIV patients. As far as we know, these two were the first cases of pneumonia due to BB to occur in this university hospital.

摘要：
背景与目的：支气管败血波氏杆菌（Bordetella bronchiseptica，BB）是一种革兰阴性球杆菌，可引发犬、猫与兔的呼吸道疾病。关于其在人类中致病的报道较为罕见，但在免疫功能低下患者，尤其是人类免疫缺陷病毒（HIV）感染者中，BB可引发严重肺部感染。本文报道某大学附属医院2例HIV阳性男性患者感染BB所致肺炎的病例。
病例报告：首例患者为43岁男性，因慢性腿痛、咳嗽就诊，初步怀疑为肺炎。痰培养分离出BB，经甲氧苄啶/磺胺甲噁唑联合左氧氟沙星治疗后痊愈。第二例患者为49岁男性，因发热、恶心、出汗及干咳就诊，同样初步怀疑为肺炎。分别从痰培养、气管分泌物及支气管肺泡灌洗液中分离出BB，予环丙沙星治疗，但患者最终死亡。
结论：免疫缺陷HIV感染者的肺炎病因应纳入支气管败血波氏杆菌。据本院所知，此2例为该院首次报道的支气管败血波氏杆菌相关性肺炎病例。