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The case describes a 59-year-old man with inflammatory bowel disease treated with biologics, presenting with persistent productive cough for 18 months and migratory lung infiltrates on computed tomography. Bronchoalveolar lavage grew B. bronchiseptica despite initial antimicrobial therapy, underscoring diagnostic challenges and the need to consider zoonotic causes in biologics-associated immunosuppression.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/chronic-productive-cough-in-an-immunosuppressed-patient-due-to-biologics-a-rare-case-of-bordetella-bronchiseptica-pulmonary-infection/442102/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/chronic-productive-cough-in-an-immunosuppressed-patient-due-to-biologics-a-rare-case-of-bordetella-bronchiseptica-pulmonary-infection/442102.png","ImageObject",300,407,{"name":92,"@type":93},"supergirl","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why did the diagnostic process remain challenging in this immunosuppressed patient?","Question",{"text":112,"@type":113},"The patient was receiving biologics for inflammatory bowel disease and had persistent symptoms with migratory lung infiltrates. Bronchoalveolar lavage ultimately cultured Bordetella bronchiseptica resistant to initial antimicrobial therapy, highlighting diagnostic complexity in immunosuppressed hosts.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What conditions and treatments were documented in the patient’s history?",{"text":117,"@type":113},"He had inflammatory bowel disease treated first with vedolizumab and later with infliximab. He also underwent thymectomy for an incidental 17 cm thymoma and received multiple antibiotic courses including clarithromycin and co-trimoxazole guided by susceptibility testing.",{"name":119,"@type":110,"acceptedAnswer":120},"How was Bordetella bronchiseptica identified and confirmed?",{"text":121,"@type":113},"Bronchoalveolar lavage was performed and culture was positive for Bordetella bronchiseptica. Gram stain showed Gram-negative coccobacilli, and culture characteristics were illustrated, supporting confirmation via bronchoscopy.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},442102,1790742370,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39},962088121634,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Respirology Case Reports  \nCLINICAL IMAGE  OPEN ACCESS   \nChronic Productive Cough in an Immunosuppressed Patient due to Biologics: A Rare Case of Bordetella bronchiseptica Pulmonary Infection  \nDebashree Banerjee1 | Eman Ayaz2 | Abby Hudson1  | Eamonn Trainor2 | Bavithra Vijayakumar3  | Harshana Bandara3   \n1Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK | 2Manchester Medical Microbiology Partnership (MMMP), Manchester University NHS Foundation Trust, Manchester, UK | 3Northwest Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK  \nCorrespondence: Harshana Bandara ([1harshanabandara@gmail.com](1harshanabandara@gmail.com))  \nReceived: 10 November 2025 | Revised: 27 November 2025 | Accepted: 13 December 2025  \nAssociate Editor: Yuanlin Song  \nKeywords: atypical infections | biologics | immunocompromised | inflammatory bowel disease  \n\n| ABSTRACT\u003Cbr>Bordetella bronchiseptica is a zoonotic pathogen that can infect immunocompromised humans. We present a 59-year-old manon immunotherapy for inflammatory bowel disease, with persistent expectorant cough for 18 months. Computed tomography (CT) demonstrated migratory lung infiltrates. Bronchoalveolar lavage cultured B. bronchiseptica resistant to initial antimicrobial therapy, highlighting the diagnostic challenges in immunosuppressed patients. |  |\n| --- | --- |\n| A 59-year-old male with a background of inflammatory bowel | Agency (UKHSA) antimicrobial reference laboratory for drug |\n| disease (IBD) who was initially treated with vedolizumab and | susceptibility testing (see Table 1). Guided by susceptibility test- |\n| subsequently with infliximab was referred to the Interstitial | ing, he was treated with a 2-week course of co-trimoxazole. This |\n| Lung Diseases (ILD) team with a suspicion of ILD due to cough | led to clinical improvement, with his long-standing cough and |\n| and abnormalities on Computed-Tomography (CT) thorax imaging. His cough was productive of green sputum, and he denied | phlegm production resolving within the first week of treatment. |\n| haemoptysis. His symptoms were unresponsive to penicillin- | B. bronchiseptica is a Gram-negative cocco-bacillus which colo- |\n| based antibiotics and doxycycline. Thoracic CT demonstrated | nises a range of mammals including dogs. It is one of the main |\n| an incidental 17 cm thymoma and peri-broncho-vascular | pathogens implicated in canine infectious respiratory disease |\n| ground-glass changes with migratory, patchy opacities. He had | complex (CIRDc), a cause of respiratory tract infections in dogs. It |\n| undergone thymectomy, but both his symptoms and ground- | is a rare zoonotic pathogen that causes infection primarily in im- |\n| glass changes persisted (Figure 1) . Symptoms improved tran- | munocompromised humans and has potentially serious sequelae |\n| siently following a course of clarithromycin. Sputum cultures | [1]. Cases have been reported in patients with HIV, solid organ |\n| showed no growth. Peripheral serum eosinophilia was noted on | transplant, stem cell transplant and malignancies [1]. Contact with |\n| the full blood count. There was no evidence of immunosuppres- | animals has been noted in these cases and our patient reported |\n| sion other than being on biologics, and the auto-immune pro- | having a pet dog. He was susceptible to infection due to immuno- |\n| file was negative. Bronchoalveolar lavage (BAL) was performed | suppression with vedolizumab and infliximab for IBD. This case |\n| which showed 50% lymphocytes, 3% eosinophils, and 2% neu- | highlights the importance of zoonotic pathogens in causing infec- |\n| trophils. BAL culture was positive for Bordetella bronchisep- | tion in those on biologics for inflammatory and rheumatological |\n| tica (Figure 2). The sample was sent to the UK Health Security | conditions. B. bronchiseptica following treatment with biologics |\n| This is an open access article under the terms of the Cr","cbCaimlQUg7ESrE3","https://ap.wps.com/l/cbCaimlQUg7ESrE3","pdf",1323314,"English","# Abstract\n## Clinical presentation and imaging\n## Microbiology and treatment course\n## Culture findings and implications\n## Antimicrobial susceptibility table","[{\"question\":\"Why did the diagnostic process remain challenging in this immunosuppressed patient?\",\"answer\":\"The patient was receiving biologics for inflammatory bowel disease and had persistent symptoms with migratory lung infiltrates. Bronchoalveolar lavage ultimately cultured Bordetella bronchiseptica resistant to initial antimicrobial therapy, highlighting diagnostic complexity in immunosuppressed hosts.\"},{\"question\":\"What conditions and treatments were documented in the patient’s history?\",\"answer\":\"He had inflammatory bowel disease treated first with vedolizumab and later with infliximab. He also underwent thymectomy for an incidental 17 cm thymoma and received multiple antibiotic courses including clarithromycin and co-trimoxazole guided by susceptibility testing.\"},{\"question\":\"How was Bordetella bronchiseptica identified and confirmed?\",\"answer\":\"Bronchoalveolar lavage was performed and culture was positive for Bordetella bronchiseptica. Gram stain showed Gram-negative coccobacilli, and culture characteristics were illustrated, supporting confirmation via bronchoscopy.\"}]","Chronic Productive Cough in an Immunosuppressed Patient due to Biologics - A Rare Case of Bordetella bronchiseptica Pulmonary Infection | PDF",1790699041]