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Case Report

Fatal Hemorrhagic Bronchopneumonia Caused by Bordetella bronchiseptica in an Immunocompetent Patient

1
Department of Internal Medicine, Temple/St. Luke’s University, Bethlehem, PA 18015, USA
2
Department of Pathology, Temple/St. Luke’s University, Bethlehem, PA 18015, USA
3
Department of Pulmonary and Critical Care, Temple/St. Luke’s University, Bethlehem, PA 18015, USA
4
Department of Infectious Disease, Temple/St. Luke’s University, Bethlehem, PA 18015, USA
*
Author to whom correspondence should be addressed.
GERMS 2023, 13(2), 172-176; https://doi.org/10.18683/germs.2023.1381
Submission received: 2 December 2022 / Revised: 10 March 2023 / Accepted: 7 May 2023 / Published: 30 June 2023

Abstract

Introduction: Bordetella bronchiseptica is a rare cause of hemorrhagic bronchopneumonia. Important to the clinician is a clear understanding that the treatment of this rare organism differs greatly from the successful antibiotic treatment of the more common Bordetella species, pertussis and parapertussis. Case report: A 64-year-old female presented to the emergency department after experiencing one week of worsening hemoptysis. Upon admission, she was afebrile and all initial laboratory test results were normal. Bronchoalveolar hemorrhage suggested by radiographic imaging was confirmed by bronchoscopy. Bronchoalveolar lavage (BAL) cultures contained unspeciated Bordetella. Rapid worsening of the hemoptysis led to intubation and the decision to perform bronchial artery embolization. However, the intensity of the hemoptysis persisted. Septic shock ensued despite treatment with broad spectrum antibiotics including azithromycin, vancomycin, and cefepime. The microbiological speciation results finalized shortly after the patient’s death. The identified organism was B. bronchiseptica. Conclusions: Although macrolide antibiotics are first line treatment for B. pertussis and parapertussis, macrolide antibiotics are generally not effective against B. bronchiseptica. Clinical suspicion of B. bronchiseptica infection should prompt consideration of alternative antibiotics known to be effective against this rare species, including carbapenems and fluoroquinolones. The use of these latter antibiotics may advisably be considered as an empirical treatment during the delay of microbiological speciation.
Keywords: Bordetella bronchiseptica; hemorrhagic bronchopneumonia; critical care; antibiotics Bordetella bronchiseptica; hemorrhagic bronchopneumonia; critical care; antibiotics

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MDPI and ACS Style

Tessier, S.; Longo, S.; Turki, M.; Numeir, M.; Le, T.; Ido, F. Fatal Hemorrhagic Bronchopneumonia Caused by Bordetella bronchiseptica in an Immunocompetent Patient. GERMS 2023, 13, 172-176. https://doi.org/10.18683/germs.2023.1381

AMA Style

Tessier S, Longo S, Turki M, Numeir M, Le T, Ido F. Fatal Hemorrhagic Bronchopneumonia Caused by Bordetella bronchiseptica in an Immunocompetent Patient. GERMS. 2023; 13(2):172-176. https://doi.org/10.18683/germs.2023.1381

Chicago/Turabian Style

Tessier, Steven, Santo Longo, Mohamed Turki, Malek Numeir, Thong Le, and Firas Ido. 2023. "Fatal Hemorrhagic Bronchopneumonia Caused by Bordetella bronchiseptica in an Immunocompetent Patient" GERMS 13, no. 2: 172-176. https://doi.org/10.18683/germs.2023.1381

APA Style

Tessier, S., Longo, S., Turki, M., Numeir, M., Le, T., & Ido, F. (2023). Fatal Hemorrhagic Bronchopneumonia Caused by Bordetella bronchiseptica in an Immunocompetent Patient. GERMS, 13(2), 172-176. https://doi.org/10.18683/germs.2023.1381

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