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Review
. 2025 Jul 11;14(7):684.
doi: 10.3390/pathogens14070684.

First Confirmed Case of Zoonotic Transmission of RR-TB from a Dog to a Human, a Neglected Mode of Mycobacterium tuberculosis Infection-Case Report and Review of the Literature

Ljiljana Zmak  1   2 , Marija Gomercic Palcic  2   3 , Mihaela Obrovac  1 , Ivana Folnozic  3 , Drazen Strelec  4 , Irena Reil  5 , Ana Miljan  6 , Maja Zdelar-Tuk  5 , Sanja Duvnjak  5 , Diana Mihalac  7 , Danka Jovetic  8 , Silvio Spicic  5
Affiliations
Review

First Confirmed Case of Zoonotic Transmission of RR-TB from a Dog to a Human, a Neglected Mode of Mycobacterium tuberculosis Infection-Case Report and Review of the Literature

Ljiljana Zmak et al. Pathogens. .

Abstract

Mycobacterium (M.) tuberculosis mostly spreads from active tuberculosis (TB) patients to human contacts, although human-to-animal and animal-to-human transmission has been described. Here, we present a rare case of rifampicin-resistant tuberculosis (RR-TB) transmission from a companion dog to its owner, highlighting the zoonotic potential of the pathogen. Namely, a 37-year-old Croatian man was diagnosed with RR-TB, with whole-genome sequencing analysis revealing a close genetic link to the strain isolated from his dog, which had died of miliary TB six years earlier. This case emphasizes the complexity of TB transmission dynamics, particularly involving companion animals, and underlines the importance of integrated "One Health" approaches for TB control. Awareness of zoonotic TB risks is essential for the early detection and prevention of cross-species transmission, especially in vulnerable populations and households with close human-animal contact.

Keywords: Mycobacterium tuberculosis; RR/MDR-TB; dog–human transmission; zoonoses.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Chest X-rays (25 April 2024). In the upper lobe of the right lung, an area of inhomogeneous opacity is observed, containing a cavity measuring 27 mm in diameter. Additionally, there are fibroadhesive and reticulonodular opacities, along with a larger soft tissue mass exhibiting nodular characteristics: (a) frontal presentation; (b) lateral presentation.
Figure 2
Figure 2
Chest CT scans (29 April 2024): (a) large cavitary lesion in the right upper lobe; (b) nodular lesion in the lower lung lobe and a discrete “tree-in-bud” pattern.
Figure 3
Figure 3
Follow-up chest X-rays (5 June 2024) show complete resolution of the previously described cavity in the right upper lobe. However, a stable soft tissue infiltrate with oval-shaped opacity persists in the same region: (a) frontal presentation; (b) lateral presentation.
Figure 4
Figure 4
Chest CT scans (7 November 2024): (a) solid lesions in upper lobe; (b) tuberculoma in the upper segment of the right lower lobe.
See this image and copyright information in PMC

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