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15 January 2019 : Case report  Japan

Acute Bronchitis Caused by Bordetella Pertussis Possibly Co-Infected with Mycoplasma Pneumoniae

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare coexistence of disease or pathology

Itsuro Kazama123ABCDEFG*, Toshiyuki Nakajima2B

DOI: 10.12659/AJCR.913430

Am J Case Rep 2019; 20:60-64

Abstract

BACKGROUND: Mycoplasma pneumoniae and Bordetella pertussis are among the causative pathogens of human acute bronchitis, which usually has mild symptoms. However, if there is a co-infection, the symptoms often can be prolonged and occasionally can lead to severe respiratory complications.

CASE REPORT: A 49-year-old Japanese female, who had not been vaccinated for B. pertussis, developed a persistent productive cough which became vigorous, and occasionally caused difficulty breathing and vomiting. Since serum IgM to M. pneumoniae was positive and IgG to B. pertussis was significantly elevated, and there were no findings of pneumonia on a chest x-ray film, we made a diagnosis of acute bronchitis caused by B. pertussis with possible co-infection with M. pneumoniae. The use of garenoxacin, a quinolone derivative, failed to work; however, a macrolide antibiotic clarithromycin dramatically improved her symptoms shortly after its administration.

CONCLUSIONS: In this patient case, because of the lymphocyte-stimulatory nature of M. pneumoniae and B. pertussis, an increased immunological response was likely to be involved in the pathogenesis of the symptoms. The immunosuppressive effect of clarithromycin was considered to repress the increased lymphocyte activity, facilitating the remission of the disease.

Keywords: Bordetella pertussis, clarithromycin, coinfection, Mycoplasma pneumoniae, Bronchitis, Pneumonia, Mycoplasma, Whooping Cough

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923