Virginia Research Day 2025

Medical Resident Research Case Reports

07 Bordetella Bronchiseptica Pneumonia and Bacteremia in a Patient with Marginal Zone Lymphoma: A Case Report of a Rare Infection

Camille Basurto, DO; Cody Smith, DO; Dexter David, DO Corresponding author: camille.basurto@hcahealthcare.com

LewisGale Medical Center, Salem, VA.

changes of the right lung, and a right-sided pleural effusion . A thoracentesis was performed and studies were consistent with an exudative process. Blood cultures and pleural fluid cultures were both positive for B. bronchiseptica . Infectious disease (ID) was consulted and recommended a 14-day course of azithromycin and a 7-day course of gentamicin. The patient was discharged with oncology and ID follow up. Discussion: Very few cases in humans have been documented of pneumonia, concomitant effusion, as well as bacteremia due to acute B. bronchiseptica infection. B. bronchiseptica typically manifests in immunocompromised patients or immunocompetent patients with underlying disease such as COPD, prior lung transplantation, HIV and/or AIDS, acute lymphocytic leukemia, or lung cancer. 3,4,5 Exposure to animals colonized with the infection is a risk factor. Given both the rarity of cases and the varying clinical presentation, from asymptomatic carriers to potentially fatal pneumonia, the standard treatment

and length of antibiotic use for B. bronchiseptica is not established for human hosts. Antibiotic administration should be generally guided by sensitivities, as B. bronchiseptica -resistant strains have been documented. 6,7 Generally, B. bronchiseptica is sensitive to antipseudomonal penicillins, fluoroquinolones, aminoglycosides except erythromycin, and carbapenems. In this case, azithromycin and gentamicin were chosen. Conclusion: Although B. bronchiseptica is a rare infection in humans, it should be considered on the differential in immunocompromised hosts presenting with pneumonia to prevent potentially fatal outcomes. IRB waiver granted by C.A.R.R.I.E. Submission ID #: 2024-1170. Protocol Title: Bordetella Bronchiseptica Pneumonia and Bacteremia in a patient with marginal zone lymphoma: a case report of a rare infection. The authors received patient consent to use their patient data for this report.

Background: Bordetella bronchiseptica is primarily a zoonotic gram-negative coccobacillus known for its highly infectious nature and protracted cough. B. bronchiseptica infections in humans are very rare, and fewer than 50 cases in bloodstream, surgical wound, and respiratory tract infections have been reported.1,2 Here, we describe a patient with marginal zone lymphoma who presented to the hospital with B. bronchiseptica pneumonia and bacteremia without known exposure to animals. Case Presentation: A 76-year-old male with a past medical history of upper lobe adenocarcinoma status post resection and adjuvant chemotherapy, marginal zone lymphoma, and heavy chain disease presented due to community-acquired pneumonia and concomitant parapneumonic effusion. Initial labs were remarkable for pancytopenia with bandemia (white cell count 1.42 x 10^3/uL, 16% banded neutrophils, red blood cell count 2.62 x 10^6/uL , hemoglobin 8.4 g/dL, platelet count 63 x 1o^3/uL). CTA chest and radiography revealed diffuse parenchymal infiltrates in the right upper and lower lobes, postsurgical

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