Bordetella bronchiseptica in non-cystic fibrosis bronchiectasis.

Bordetella bronchiseptica is a rare pulmonary infection, often associated with zoonotic transmission. It has been described in immunocompromised patients and those with underlying pulmonary disease. However, there are no case series describing the spectrum of disease caused by Bordetella bronchiseptica in patients with non-cystic fibrosis bronchiectasis. Here, we report three cases of Bordetella bronchiseptica infection in patients with non-cystic fibrosis bronchiectasis and highlight the pathophysiology of the microbe. While the clinical presentation can be quite variable, it is important to note that Bordetella bronchiseptica can be a cause of pulmonary exacerbations and can be difficult to eradicate.

New therapeutic options for noncystic fibrosis bronchiectasis.

PURPOSE OF REVIEW: Patients with noncystic fibrosis bronchiectasis (NCFB) share many of the respiratory symptoms of cystic fibrosis and often are provided therapies effective in cystic fibrosis, often without clear evidence of benefit. There are currently no approved therapies for NCFB, but in recent years, there has been increased interest in developing new therapies due to the increasing prevalence and perceived unmet needs. This review is meant to provide the most recent information to clinicians about currently available and pipeline therapies for NCFB. RECENT FINDINGS: Inhaled antibiotics may provide effective bacterial suppressive therapy with an acceptable safety profile in adults with NCFB, although evidence of improved outcomes is limited. Inhaled hyperosmolar agents such as hypertonic saline and mannitol are promising but study results have been mixed. Macrolide antibiotics have anti-inflammatory properties and, in several randomized controlled trials, demonstrated the benefit of chronic low-dose treatment. Other anti-inflammatory agents that have shown promising preliminary results include statins and neutrophil elastase inhibitors. SUMMARY: There is high-quality evidence supporting chronic low-dose macrolide therapy in patients with NCFB. There is limited evidence of benefit of other therapies, including inhaled antibiotics and pharmacologic agents to enhance mucus clearance.

Reversible bronchiectasis in an adult: a case report.

Bronchiectasis is classically defined as irreversible bronchial dilatation that represents the sequelae of chronic airway inflammation and is permanent, reflecting the presence of bronchiectasis. It is increasingly being recognized with the wider availability of high-resolution computed tomography. In contrast to adults, children with noncystic fibrosis bronchiectasis may have resolution or significant improvement in bronchial dilatation. We report a case of reversible bronchial dilatation in an adult as evidenced by high-resolution computed tomography, which demonstrates that, although quite rare in adults, spontaneous resolution may occur.