Infections with the agent of 'kennel cough' in patients with cancer. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Szvalb, Ariel D.; Rolston, Kenneth V.; Mori, Nobuyoshi; Tarrand, Jeffrey J.; Mulanovich, Victor E.
• Is Part Of: Journal of infection. Volume 78:Issue 1(2019)
• Page Start: 48
• Page End: 53
• Publication Date: 2019-01
• Subjects: Bordetella bronchiseptica -- Respiratory tract infection -- Zoonosis -- Kennel cough in humans; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2018.07.010
• Languages: English
• ISSNs: 0163-4453

Abstract

Highlights: Even in immunosuppressed patients, B. bronchiseptica is an uncommon pathogen. The predominant sites of infection are the respiratory tract and bloodstream. B. bronchiseptica infections have no specific clinical or radiographic manifestations. B. bronchiseptica should always be considered pathogenic in immunocompromised hosts. Summary: Objective: To investigate the clinical manifestations, microbiological data, and outcomes of Bordetella bronchiseptica (Bb) infections in patients with cancer. Methods: Review of electronic medical records of 24 patients with Bb infection, from 2000 to 2013. An infection was considered to be associated with Bb if both clinical manifestations plus microbial growth from infected sites were present. Results: Ten patients (42%) had a monomicrobial infection, whereas multiple pathogens in addition to Bb were isolated from the rest (14 patients, 58%). The most frequent sites of infection were the respiratory tract (18 patients, 75 %) and bloodstream (17%). The most frequently associated conditions were lymphopenia (71%), tobacco use (42%), and chemotherapeutic or immunosuppressive agents (33% each). Animal exposure was established in four patients. Overall, the response rate to treatment was 100% for monomicrobial and 79% for polymicrobial infections, respectively. Conclusions: Bb is an uncommon pathogen even in immunosuppressed patients. Predominant sites of infection are the respiratory tract and bloodstream. Bb should be considered pathogenic in immunocompromised hosts, particularly with history of zoonotic exposure, even if accompanied by co-pathogens. Therefore, contact with potential animal sources should be minimized. The infection ranges from mild to severe and has no specific clinical or radiographic manifestations.