Human infection with zoonotic agent and COPD exacerbation in late course of endoscopic lung-volume reduction

We report the case of a 68-year-old man with prolonged chronic obstructive pulmonary disease (COPD) exacerbation attributed to a <i>Bordetella bronchiseptica</i> infection in the late course of endoscopic lung-volume reduction (ELVR). This severe emphysematous patient initially experienced significant symptomatic improvement after the successful placing of two one-way endobronchial Zephyr valves in his left upper lobe in September 2019. Three months later, the patient presented to follow-up consultation with sustained and prolonged asthenia, significant increased dyspnoea and productive cough, consistent with COPD exacerbation. Blood tests showed slight inflammatory syndrome. Chest-computed tomography revealed bronchiolitis pattern of the right lower lobe. Sputum cultures revealed <i>Bordetella bronchiseptica</i>. Fiberoptic bronchoscopy confirmed purulent secretions all around the well-positioned and functional endobronchial valves. Endobronchial sampling cultures around the valves confirmed massive presence of <i>Bordetella bronchiseptica</i>. According to the bacterial antibiogram, we initiate a ten days intravenous piperacillin-tazobactam antibiotic treatment with good clinical evolution and negativation of the inflammatory syndrome. Human <i>Bordetella bronchiseptica</i> respiratory tract infection is rare, often associated with zoonotic transmission and more frequently described in immunocompromised patients and those with underlying pulmonary disease. Evidence of increased bacterial colonization after valve implantation exists. To our knowledge, there is however no previous description of <i>Bordetella bronchiseptica</i> respiratory tract infection after ELVR.