Ner Zarah, Ross Lawrence A, Horn Monica V, Keens Thomas G, MacLaughlin Eithne F, Starnes Vaughn A, Woo Marlyn S
Division of Pediatric Pulmonology, Department of Pediatrics, Childrens Hospital Los Angeles, Keck-USC School of Medicine, Los Angeles, CA 90027, USA.
Pediatr Transplant. 2003 Oct;7(5):413-7. doi: 10.1034/j.1399-3046.2003.00074.x.
Bordetella bronchiseptica are small, pleomorphic Gram-negative coccobacilli which are commensal organisms in the upper respiratory tract of many wild and domestic animals ('kennel cough' in dogs). While it is common for health care providers to ask about exposure to ill family/friends, most do not routinely inquire about the health or immunization status of household pets. We report two cases of B. bronchiseptica pneumonia in lung transplant recipients [cystic fibrosis (CF); ages 10 and 15 yr; one male] who contracted B. bronchiseptica from pet dogs. We compared their course and outcome to four children (two CF, one congenital heart disease and one Duchenne's muscular dystrophy; four males, age range 6 months to 14 yr) with B. bronchiseptica cultured from the respiratory tract. Two of the four patients also acquired their illnesses from pet dogs and two from unknown sources. One lung transplant recipient expired from progressive respiratory failure. We conclude that B. bronchiseptica can cause serious infections in both immunosuppressed and immunocompetent children. We speculate that a detailed history of exposure to ill pets (particularly dogs), and the immunization status of all pets should be included in the routine evaluation of all pediatric transplant recipients.
支气管败血波氏杆菌是一种小型、多形性的革兰氏阴性球杆菌，是许多野生动物和家畜上呼吸道的共生菌（犬窝咳）。虽然医护人员通常会询问患者是否接触过患病的家人/朋友，但大多数人不会常规询问家庭宠物的健康状况或免疫状态。我们报告了两例肺移植受者（囊性纤维化；年龄分别为10岁和15岁；一名男性）感染支气管败血波氏杆菌肺炎的病例，他们是从宠物狗感染的。我们将他们的病程和结局与另外四名呼吸道培养出支气管败血波氏杆菌的儿童（两名囊性纤维化患者、一名先天性心脏病患者和一名杜氏肌营养不良患者；四名男性，年龄范围为6个月至14岁）进行了比较。这四名患者中有两名也是从宠物狗感染，另外两名感染源不明。一名肺移植受者因进行性呼吸衰竭死亡。我们得出结论，支气管败血波氏杆菌可在免疫抑制和免疫功能正常的儿童中引起严重感染。我们推测，在所有儿科移植受者的常规评估中，应包括详细的接触患病宠物（特别是狗）的病史以及所有宠物的免疫状态。
