1887

Abstract

In addition to , about 20 species have been documented as human pathogens. The majority of infections by non- species occur in immunocompromised and splenectomized patients. Here, we report a case of ‘classical’ lobar pneumonia caused by in a splenectomized patient receiving corticosteroids for chronic immune thrombocytopenia. Tests for antigen were negative. was immediately detected in bronchoalveolar fluid by PCR and subsequently confirmed by culture on legionella-selective media. The features of Legionnaires' disease in immunocompromised patients with special emphasis on significance and detection of non- species are reviewed.

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2008-03-01
2019-11-14
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References

  1. Bencini, M. A., van den Brule, A. J., Claas, E. C., Hermans, M. H., Melchers, W. J., Noordhoek, G. T., Salimans, M. M., Schirm, J., Vink, C. & other authors ( 2007; ). A multicenter comparison of molecular methods for the detection of Legionella in sputum samples. J Clin Microbiol 45, 3390–3392.[CrossRef]
    [Google Scholar]
  2. Benin, A. L., Benson, R. F. & Besser, R. E. ( 2002; ). Trends in legionnaires disease, 1980–1998: declining mortality and new patterns of diagnosis. Clin Infect Dis 35, 1039–1046.[CrossRef]
    [Google Scholar]
  3. Bottger, E. C. ( 1989; ). Rapid determination of bacterial ribosomal RNA sequences by direct sequencing of enzymatically amplified DNA. FEMS Microbiol Lett 53, 171–176.
    [Google Scholar]
  4. British Thoracic Society Standards of Care Committee ( 2001; ). BTS guidelines for the management of community acquired pneumonia in adults. Thorax 56 (Suppl. 4), IV1–IV64.[CrossRef]
    [Google Scholar]
  5. Diederen, B. M., de Jong, C. M., Kluytmans, J. A., van der Zee, A. & Peeters, M. F. ( 2006; ). Detection and quantification of Legionella pneumophila DNA in serum: case reports and review of the literature. J Med Microbiol 55, 639–642.[CrossRef]
    [Google Scholar]
  6. Di Stefano, F., Verna, N. & Di Gioacchino, M. ( 2007; ). Cavitary Legionella pneumonia in a patient with immunodeficiency due to Hyper-IgE syndrome. J Infect 54, e121–e123.[CrossRef]
    [Google Scholar]
  7. Dowling, J. N., Kroboth, F. J., Karpf, M., Yee, R. B. & Pasculle, A. W. ( 1983; ). Pneumonia and multiple lung abscesses caused by dual infection with Legionella micdadei and Legionella pneumophila. Am Rev Respir Dis 127, 121–125.
    [Google Scholar]
  8. Fang, G. D., Stout, J. E., Yu, V. L., Goetz, A., Rihs, J. D. & Vickers, R. M. ( 1990; ). Community-acquired pneumonia caused by Legionella dumoffii in a patient with hairy cell leukemia. Infection 18, 383–385.[CrossRef]
    [Google Scholar]
  9. Fraser, T. G., Zembower, T. R., Lynch, P., Fryer, J., Salvalaggio, P. R., Yeldandi, A. V. & Stosor, V. ( 2004; ). Cavitary Legionella pneumonia in a liver transplant recipient. Transpl Infect Dis 6, 77–80.[CrossRef]
    [Google Scholar]
  10. Garcia, C., Ugalde, E., Campo, A. B., Minambres, E. & Kovacs, N. ( 2004; ). Fatal case of community-acquired pneumonia caused by Legionella longbeachae in a patient with systemic lupus erythematosus. Eur J Clin Microbiol Infect Dis 23, 116–118.[CrossRef]
    [Google Scholar]
  11. Gorelik, O., Lazarovich, Z., Boldur, I., Almoznino-Sarafian, D., Alon, I., Modai, D. & Cohen, N. ( 2004; ). Legionella in two splenectomized patients. Coincidence or causal relationship? Infection 32, 179–181.[CrossRef]
    [Google Scholar]
  12. Jaeger, T. M., Atkinson, P. P., Adams, B. A., Wright, A. J. & Hurt, R. D. ( 1988; ). Legionella bozemanii pneumonia in an immunocompromised patient. Mayo Clin Proc 63, 72–76.[CrossRef]
    [Google Scholar]
  13. Jernigan, D. B., Sanders, L. I., Waites, K. B., Brookings, E. S., Benson, R. F. & Pappas, P. G. ( 1994; ). Pulmonary infection due to Legionella cincinnatiensis in renal transplant recipients: two cases and implications for laboratory diagnosis. Clin Infect Dis 18, 385–389.[CrossRef]
    [Google Scholar]
  14. Korman, T. M., Fuller, A., Ibrahim, J., Kaye, D. & Bergin, P. ( 1998; ). Fatal Legionella longbeachae infection following heart transplantation. Eur J Clin Microbiol Infect Dis 17, 53–55.[CrossRef]
    [Google Scholar]
  15. Lang, R., Wiler, Z., Manor, J., Kazak, R. & Boldur, I. ( 1990; ). Legionella longbeachae pneumonia in a patient splenectomized for hairy-cell leukemia. Infection 18, 31–32.[CrossRef]
    [Google Scholar]
  16. Mandell, L. A., Wunderink, R. G., Anzueto, A., Bartlett, J. G., Campbell, G. D., Dean, N. C., Dowell, S. F., File, T. M., Jr, Musher, D. M. & other authors ( 2007; ). Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 44 (Suppl. 2), S27–S72.[CrossRef]
    [Google Scholar]
  17. McClelland, M. R., Vaszar, L. T. & Kagawa, F. T. ( 2004; ). Pneumonia and osteomyelitis due to Legionella longbeachae in a woman with systemic lupus erythematosus. Clin Infect Dis 38, e102–e106.[CrossRef]
    [Google Scholar]
  18. McKinney, R. M., Porschen, R. K., Edelstein, P. H., Bissett, M. L., Harris, P. P., Bondell, S. P., Steigerwalt, A. G., Weaver, R. E., Ein, M. E. & other authors ( 1981; ). Legionella longbeachae species nova, another etiologic agent of human pneumonia. Ann Intern Med 94, 739–743.[CrossRef]
    [Google Scholar]
  19. Muder, R. R. & Yu, V. L. ( 2002; ). Infection due to Legionella species other than L. pneumophila. Clin Infect Dis 35, 990–998.[CrossRef]
    [Google Scholar]
  20. Muder, R. R., Yu, V. L. & Parry, M. F. ( 1987; ). The radiologic manifestations of Legionella pneumonia. Semin Respir Infect 2, 242–254.
    [Google Scholar]
  21. O'Connor, B. A., Carman, J., Eckert, K., Tucker, G., Givney, R. & Cameron, S. ( 2007; ). Does using potting mix make you sick? Results from a Legionella longbeachae case-control study in South Australia. Epidemiol Infect 135, 34–39.[CrossRef]
    [Google Scholar]
  22. Pedro-Botet, M. L., Stout, J. E. & Yu, V. L. ( 2002; ). Legionnaires' disease contracted from patient homes: the coming of the third plague? Eur J Clin Microbiol Infect Dis 21, 699–705.[CrossRef]
    [Google Scholar]
  23. Poupard, M., Campese, C., Bernillon, P. & Che, D. ( 2007; ). Factors associated with mortality in Legionnaires' disease, France, 2002–2004. Med Mal Infect 37, 325–330.[CrossRef]
    [Google Scholar]
  24. Radaelli, F., Langer, M., Chiorboli, O., Proietti, D. & Baldini, L. ( 1991; ). Severe Legionella pneumophila infection in a patient with hairy cell leukemia in partial remission after alpha interferon treatment. Hematol Oncol 9, 125–128.
    [Google Scholar]
  25. Roig, J. & Rello, J. ( 2003; ). Legionnaires' disease: a rational approach to therapy. J Antimicrob Chemother 51, 1119–1129.[CrossRef]
    [Google Scholar]
  26. Schlossberg, D. & Bonoan, J. ( 1998; ). Legionella and immunosuppression. Semin Respir Infect 13, 128–131.
    [Google Scholar]
  27. Schwebke, J. R., Hackman, R. & Bowden, R. ( 1990; ). Pneumonia due to Legionella micdadei in bone marrow transplant recipients. Rev Infect Dis 12, 824–828.[CrossRef]
    [Google Scholar]
  28. Senecal, J. L., St Antoine, P. & Beliveau, C. ( 1987; ). Legionella pneumophila lung abscess in a patient with systemic lupus erythematosus. Am J Med Sci 293, 309–314.[CrossRef]
    [Google Scholar]
  29. Singh, N., Stout, J. E. & Yu, V. L. ( 2002; ). Legionnaires's disease in a transplant recipient acquired from the patient's home: implications for management. Transplantation 74, 755–756.[CrossRef]
    [Google Scholar]
  30. Sopena, N., Sabria-Leal, M., Pedro-Botet, M. L., Padilla, E., Dominguez, J., Morera, J. & Tudela, P. ( 1998; ). Comparative study of the clinical presentation of Legionella pneumonia and other community-acquired pneumonias. Chest 113, 1195–1200.[CrossRef]
    [Google Scholar]
  31. Stout, J. E. & Yu, V. L. ( 1997; ). Legionellosis. N Engl J Med 337, 682–687.[CrossRef]
    [Google Scholar]
  32. Tan, M. J., Tan, J. S., Hamor, R. H., File, T. M., Jr & Breiman, R. F. ( 2000; ). The radiologic manifestations of Legionnaire's disease. The Ohio Community-Based Pneumonia Incidence Study Group. Chest 117, 398–403.[CrossRef]
    [Google Scholar]
  33. Wilkinson, H. W., Thacker, W. L., Benson, R. F., Polt, S. S., Brookings, E., Mayberry, W. R., Brenner, D. J., Gilley, R. G. & Kirklin, J. K. ( 1987; ). Legionella birminghamensis sp. nov. isolated from a cardiac transplant recipient. J Clin Microbiol 25, 2120–2122.
    [Google Scholar]
  34. Yu, V. L., Plouffe, J. F., Pastoris, M. C., Stout, J. E., Schousboe, M., Widmer, A., Summersgill, J., File, T., Heath, C. M. & other authors ( 2002; ). Distribution of Legionella species and serogroups isolated by culture in patients with sporadic community-acquired legionellosis: an international collaborative survey. J Infect Dis 186, 127–128.[CrossRef]
    [Google Scholar]
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