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B. Bronchiseptica empyema necessitans, a case report
Samantha Wray1, Nikko Rowe A Tabliago2, Richard Lueking2
1Division of Hospital Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave 8th Floor, Charleston, SC, 29425, USA. saw304@musc.edu.
BMC Pulmonary Medicine
|May 9, 2025
Summary
This case study reports the first instance of empyema necessitans caused by Bordetella bronchiseptica, an emerging zoonosis. The condition resulted from repeated animal exposure in a dog trainer, highlighting a rare complication.
Area of Science:
- Medical microbiology
- Infectious diseases
- Pulmonology
Background:
- Empyema necessitans is a rare complication of empyema, involving pus extension into the chest wall.
- Management typically requires both medical and surgical interventions.
- This study identifies the first case of empyema necessitans caused by Bordetella bronchiseptica.
Purpose of the Study:
- To report the first case of empyema necessitans caused by Bordetella bronchiseptica.
- To highlight the potential for Bordetella bronchiseptica as an emerging zoonotic pathogen.
- To discuss the unusual presentation of empyema necessitans secondary to animal exposure.
Main Methods:
- A 60-year-old female dog trainer presented with a chest wall lesion.
- Imaging revealed right-sided empyema with chest wall fistulization.
- Diagnosis was confirmed by Gram stain and cultures isolating Bordetella bronchiseptica, followed by antibiotic treatment and surgical intervention (Clagett window).
Main Results:
- Bordetella bronchiseptica was repeatedly isolated from pleural and chest wall collections.
- The patient showed a chronic pleural collection with a communicating chest wall gas-fluid collection, consistent with empyema necessitans.
- Treatment involved antibiotics (moxifloxacin) and a Clagett window procedure.
Conclusions:
- Bordetella bronchiseptica, previously considered exclusively animal-specific, is an emerging zoonosis.
- Empyema necessitans due to Bordetella bronchiseptica following animal exposure represents an unprecedented complication.
- This case underscores the importance of considering zoonotic pathogens in unusual presentations of infectious diseases.
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