A rare case of Bordetella avium pneumonia complicated by Rao
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Researchers report, to their knowledge, the first case of B avium pneumonia complication by a rare opportunistic pathogen R planticola in a patient with direct attributable environment exposure risk—the work at a bird farm. The problems of B avium identification still persist.

A 52‐year‐old man with a 25‐pack year smoking history and medical history of arterial hypertension, dyscirculatory encephalopathy and chronic pyelonephritis presented to our department with complaints of weakness, fatigue, cough with mucopurulent sputum, and right‐sided moderate chest pain for 5 days. He received paracetamol 500 mg b.i.d., enalapril 10 mg, bisoprolol 10 mg, and acetylsalicylic acid 75 mg. On admission, physical examination revealed a mildly ill‐appearing white male, alert, and oriented, with acrocyanosis. A plain chest radiography on admission showed a right‐sided pleuropneumonia predominantly in the middle lobe.

Empirically, ceftriaxone 1000 mg (one time), moxifloxacin 400 mg, and ambroxol were given intravenously. Sputum culture showed Metylobacterium mesophilicum, Viridans group streptococci, and Candida spp. M mesophilicum isolate was identified as Bordetella avium with a sensitivity to most antibiotics.

Repeated sputum culture (on day 7 after hospitalization) showed Klebsiella pneumonia, Hemophilus parainfluenzae, and Rothia (Stomatococcus) mucilanginous. Isolate of K pneumoniae was identified as Raoultella planticola with a sensitivity to antibiotics. Blood culture was sterile. In serum, no antibodies to HIV were detected. Doctors continued the therapy with moxifloxacin up to 10 days.

Source: https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.2800