Article in Japanese

A case of primary ciliary dyskinesia complicated with refractory pasteurellosis

Saki OTSUKI¹⁾, Yoshiaki WATANABE²⁾, Hideki MOTOMURA²⁾, Hiroyuki MORIUCHI³⁾

Pasteurella multocida, a zoonotic pathogen, is transmitted to human through close contact with infected animals, and causes opportunistic infections in elderly persons, neonates, or patients with underlying diseases, such as bronchiectasis. Primary ciliary dyskinesia (PCD) is one of the underlying causes of bronchiectasis in children. We herein report a case of refractory pasteurellosis that was later diagnosed as PCD. A 13-year-old boy with a history of four admissions due to pneumonia presented with fever and cough, and was admitted with a diagnosis of pneumonia. Sputum culture yielded P. multocida, although he had no history of animal contact. He was treated with intravenous administration of minocycline, followed by amoxicillin. Chest computed tomography demonstrated bronchiectasis. After discharge, he repeated episodes of fever and cough with sputum cultures positive for P. multicida, suggesting exacerbation of pulmonary pasteurellosis. Investigation of a possible underlying condition revealed PCD. He has not had exacerbation since he was treated with high-dose amoxicillin and respiratory physical therapy. It is necessary to investigate the possibility of PCD and other underlying diseases in pediatric cases of refractory pasteurellosis, especially when transmission route is not known.

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1) Department of Pediatrics Initial Resident, National Hospital Organization, Nagasaki Medical Center
2) Department of Pediatrics, National Hospital Organization, Nagasaki Medical Center
3) Department of Pediatrics, Nagasaki University, Graduate School of Biomedical Sciences

Key words	Pasteurella, primary ciliary dyskinesia; PCD, bronchiectasis
Received	September 10, 2019
Accepted	January 23, 2020

32 (2)：115─121,2020