Bordetella holmesii-like organisms associated with septicemia, endocarditis, and respiratory failure. Clin Infect Dis

We recovered an unusual bacterial strain from blood or sputum of three patients with septicemia, endocarditis, and/or respiratory failure. The three isolates were thin, curved, gram-negative, light brown, pigment-producing bacilli with variable catalase activity. They were asaccharolytic, oxidase-negative, nonmotile, and fastidious. Identification was not possible on the basis of these characteris-tics alone or in combination with cellular fatty acid profiles. Nucleic acid amplification and sequence analysis of the 16S rRNA gene revealed that all three isolates were identical and most closely related to the emerging pathogen Bordetella holmesii, diverging from the published sequence at three nucleotide positions (99.8 % similarity). Isolation of a B. holmesii–like pathogen from sputum sug-gests that, in addition to producing septicemia, the organism may inhabit the respiratory tract like other Bordetella species. We describe three patients who developed septicemia, endo- pulse, 95/minute; respirations, 24/minute; and blood pressure, 112/66 mm Hg. His head, eyes, ears, nose, and throat appearedcarditis, and/or respiratory failure due to a Bordetella holmesii– like bacterium that was identified only with use of nucleic acid normal on examination, and the lungs were clear. The blood hemoglobin level was 15.2 g/dL, the platelet count wasamplification and sequence analysis of 16S rRNA. 407,000/mm3, and the leukocyte count was 37,500/mm3, wit