Abstract Introduction In recent decades, the role of companion animals has shifted from providing security or pest control to becoming integral family members. Such direct human-pet interactions, including face-licking and bed-sharing, increase the risk of zoonotic transmission, which is a central concern of the One Health framework. Bordetella bronchiseptica is a gram-negative coccobacillus of the Alcaligenaceae family, known to cause respiratory disease in several animal species and is capable of infecting humans. Description A 74-year-old Hispanic man presented with a productive cough, yellow sputum, exertional dyspnea, pleuritic pain, and 8 kg unintentional weight loss, all persisting for 3 years. His past medical history included a right upper lobectomy 57-years prior and pulmonary tuberculosis confirmed by sputum AFB+ in 2022, treated for 6 months without symptomatic improvement. Although the patient had seen different specialists for years, bronchoscopy was never performed to establish a definitive diagnosis and treatment. Auscultation revealed bilateral diffuse ronchi. His St. George's Respiratory Questionnaire (SGRQ) score was 65%, indicating poor quality of life (QoL). Chest CT revealed bilateral centrilobular nodules with a tree-in-bud pattern, apical subsegmental atelectasis, bronchiectasis, peribronchial thickening, and consolidation with air bronchograms in the left lung. Spirometry and Diffusion Lung Capacity for Carbon Monoxide were normal. HIV test was negative. Upon further interrogation, he revealed close contact with coughing dogs, one of which had died from an undiagnosed respiratory illness. Bronchoscopy with bronchoalveolar lavage (BAL) ruled out tuberculosis (GenXpert) and malignancy (transbronchial biopsy). Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF A nasal swab from his ill dog confirmed the same pathogen. The patient was treated with levofloxacin (500 mg daily for 14 days). Six months post-treatment, the patient regained weight and was symptom-free. Repeat chest CT demonstrated marked improvement, showing bronchiectasis with decreased peribronchial thickening and absence of consolidation. Finally, his QoL improved in the SQRQ, with a total score of 9%. (Fig. 1). Discussion Zoonosis transmission has increased, reflecting a serious concern for the One Health global strategy, which requires cooperation between professionals. Clinicians should systematically inquire about research when evaluating patients with atypical respiratory symptoms, as illustrated in this immunocompetent case. Alternatively, accurate and timely pathogen identification is essential for both patient management and zoonotic surveillance; therefore, bronchoscopy with BAL should not be delayed. This clinical presentation and prolonged microbiological confirmation in both the patient and his pet underscore the importance of clinical suspicion of zoonotic pathogens in an appropriate context. This abstract is funded by: None
Cherrez-Ojeda et al. (Fri,) studied this question.