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Transpl Infect Dis ; 12(1): 73-6, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19874567

RESUMEN

Bordetella bronchiseptica is an uncommon cause of respiratory infection in humans generally occurring in immunocompromised individuals exposed to infected animals. A 61-year-old female underwent a kidney-pancreas transplant 7 years before presentation. Postoperative immunosuppression was achieved with sirolimus and mycophenolate mofetil. The patient was doing well until she developed a small bowel obstruction secondary to adhesions. She underwent surgical adhesiolysis without complications. Two weeks postoperatively the patient developed pneumonia. She failed to respond to repeated courses of antibiotics, and thus, diagnostic bronchoscopy with bronchoalveolar lavage (BAL) was performed. BAL cultures grew B. bronchiseptica. Further investigation revealed that the patient's dogs had recently received a live-attenuated B. bronchiseptica intranasal vaccination. The patient recovered after 21 days of therapy with doxycycline based upon in vitro susceptibility testing. B. bronchiseptica is an uncommon but recognized human pathogen. It most commonly affects immunocompromised individuals. Here, we report a culture-proven case of B. bronchiseptica pneumonia in an immunocompromised host residing in a household with her dogs who had recently received live-attenuated, intranasal B. bronchiseptica vaccinations. As polymerase chain reaction testing was not performed comparing the isolated strain to the vaccination strain, the association is presumptive. This report expands the spectrum of immunocompromised hosts to include renal-pancreas transplant patients who have developed infection from B. bronchiseptica, while illustrating the risks associated with animal contacts and attenuated vaccines in the immunosuppressed population.


Asunto(s)
Vacunas Bacterianas/administración & dosificación , Infecciones por Bordetella/veterinaria , Bordetella bronchiseptica , Enfermedades de los Perros/prevención & control , Trasplante de Riñón/efectos adversos , Trasplante de Páncreas/efectos adversos , Neumonía Bacteriana/microbiología , Animales , Infecciones por Bordetella/microbiología , Infecciones por Bordetella/prevención & control , Bordetella bronchiseptica/inmunología , Bordetella bronchiseptica/aislamiento & purificación , Enfermedades de los Perros/microbiología , Perros , Femenino , Humanos , Persona de Mediana Edad , Neumonía Bacteriana/prevención & control , Neumonía Bacteriana/veterinaria , Vacunación/veterinaria , Vacunas Atenuadas/administración & dosificación , Zoonosis/microbiología , Zoonosis/transmisión
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