1/43. Relapsing life threatening community acquired pneumonia due to rare Legionella species responsive to ceftriaxone and aztreonam.A 24 year old Saudi housewife was admitted thrice with life threatening community acquired pneumonia. Even though she responded to an initial cocktail of cefriaxone, erythromcin, rifampicin and flucloxacillin during the second admission, she relapsed within four days of discharge when she was on erythromycin only. During the third admission she was put on ceftriaxone and aztreonam and recovered fully without any relapse. serology results received later showed Legionella IgM titres of more than 1:256 for Legionella micdadei and Legionella bozemanii, and IgG titres of Legionella hackeliae. This case demonstrates relapsing pneumonia due to Legionella micdadei and bozemanii infection, and previous exposure to Legionella hackeliae. Both species, that is, Legionella micdadei and bozemanii, are resistant to erythromycin, but responded very well to a combination of ceftriaxone and aztreonam have not been used previously for the treatment of Legionnaires diseases.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
2/43. Isolation of Legionella anisa using an amoebic coculture procedure.Conventional diagnostic tests for legionellosis were negative for a 61-year-old immunocompromised man with pneumonia. However, coculture of a sputum sample with acanthamoeba polyphaga amoebae led to the recovery of Legionella anisa. This procedure may be a sensitive and convenient diagnostic method, especially for non-legionella pneumophila species infections that can be diagnosed only by culture.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
3/43. Legionella-like and other amoebal pathogens as agents of community-acquired pneumonia.We tested serum specimens from three groups of patients with pneumonia by indirect immunofluorescence against Legionella-like amoebal pathogens (LLAPs) 1-7, 9, 10, 12, 13; Parachlamydia acanthamoeba strains BN 9 and Hall's coccus; and afipia felis. We found that LLAPs play a role (albeit an infrequent one) in community-acquired pneumonia, usually as a co-pathogen but sometimes as the sole identified pathogen.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
4/43. An outbreak of legionella longbeachae infection in an intensive care unit?During a nine-day period, five patients in a 14-bed intensive care unit (ICU) were shown to have seroconverted with a four-fold or greater rise in serum antibody titre to legionella longbeachae serogroup 1. A further two patients were observed to have high titres consistent with previous exposure but earlier serum samples were not available for comparison. No patients had antibody responses to legionella pneumophila serogroups 1 and 2. L. longbeachae was not cultured from respiratory secretions from patients or from the environment within the unit. Legionella anisa was recovered from one cooling tower on the ninth floor of the tower block. The ICU is located on the first floor of the same tower and receives external air from two vents, one on the eastern and the other on the western aspect. All patients with serological evidence of L. longbeachae infection were concomitantly infected with multiresistant staphylococcus aureus, and were located in bays on the eastern side of the unit. A large pigeon nest was discovered within 1-2 m of the eastern vent. Following removal of the birds' nest, no further cases were seen on routine screening of all patients within the unit over the next eight weeks. Alternatively, seroconversion may have been related to demolition of the adjacent nine-storey nurses home. This was begun one month before the first case was diagnosed and was completed four months later. The periodic northerly winds could have carried legionellae from the demolition site directly over the block housing the ICU and may have concentrated them near the eastern air vent. All patients had pneumonia, which was probably multifactorial in origin. There is some uncertainty whether the serological responses seen were an epiphenomenon or were truly indicative of infection with L. longbeachae.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
5/43. Fatal case of community-acquired pneumonia caused by legionella longbeachae in a patient with systemic lupus erythematosus.Reported here is a rare case of atypical pneumonia due to a non- pneumophila Legionella sp. that occurred in a young patient with systemic lupus erythematosus. In spite of aggressive treatment, the patient died 24 h following admission to the intensive care unit. legionella longbeachae was cultured from respiratory tract specimens and identified to the genus level by PCR and to the species level by an immunofluorescence test. Since most current laboratory tests for Legionella spp., including urinary antigen and serology, cannot detect infections caused by non- pneumophila Legionella spp., culture on legionella-selective media should be strongly considered when diagnosing immunosuppressed patients with pneumonia.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
6/43. Legionella micdadei infection presenting as severe secretory diarrhea and a solitary pulmonary mass.Sixty percent of infections with non-pneumophila species of Legionella are caused by Legionella micdadei. Although diarrhea is a common symptom of legionellosis, including that due to L. micdadei infection, severe, life-threatening diarrhea is rare. We describe a patient with profound secretory diarrhea (secretion rate, up to 8 L/day) that was secondary to culture-proven L. micdadei pneumonia. In addition, a 3-cm pulmonary nodule was detected, which completely resolved after proper treatment for Legionella infection. Resolving pulmonary nodules have been previously reported in association with treatment of L. micdadei infections.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
7/43. pneumonia and osteomyelitis due to legionella longbeachae in a woman with systemic lupus erythematosus.A patient with risk factors of systemic lupus erythematosus, corticosteroid use, and malignancy received a diagnosis of concomitant pneumonia and osteomyelitis caused by legionella longbeachae. In this report, the first description of Legionella osteomyelitis, previous cases of extrapulmonary Legionella infection are detailed.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
8/43. pneumonia due to Legionella bozemanii and chlamydia psittaci/TWAR following renal transplantation.chlamydia and Legionella are recognized causes of atypical pneumonia. A case of pneumonia due to chlamydia psittaci/TWAR and Legionella bozemanii following renal transplantation is described. Legionella bozemanii infection was diagnosed by a rise in antibodies and by isolation of the organism from bronchoscopy specimens. It is unusual to find pneumonia caused concomitantly by two such agents. This case, despite the fatal outcome, emphasises the necessity for a comprehensive approach to the diagnosis of atypical pneumonia, including culture for Legionella, especially in immunocompromised patients.- - - - - - - - - - ranking = 0.66666666666667keywords = pneumonia (Clic here for more details about this article) |
9/43. Legionella micdadei pneumonia diagnosed by culture isolation and dna-dna hybridization from bronchial lavage fluid.An 80-year-old man was admitted because of dyspnea on effort. We suspected an acute exacerbation of chronic heart failure and idiopathic interstitial pneumonia caused by right-sided pneumonia. A nodular shadow in right upper lobe spread and consolidated into the airspace, and it failed to improve despite administration of meropenem trihydrate, vancomycin hydrochloride and clindamycin. A definitive diagnosis of Legionella micdadei pneumonia was made on the basis of this organism being isolated in culture from bronchial lavage fluid and subsequent identification of Legionella micdadei using dna-dna hybridization. The airspace consolidation gradually improved following treatment with intravenous erythromycin and minocycline hydrochloride.- - - - - - - - - - ranking = 1.1666666666667keywords = pneumonia (Clic here for more details about this article) |
10/43. Abscess and empyema caused by Legionella micdadei.Legionella micdadei is the second most common species implicated in the occurrence of Legionella pneumonia (D. J. Bremer, Semin. Respir. Infect. 4:190-205, 1987). Although there has been a reported lung abscess caused by dual infection (L. micdadei and L. pneumophila), there are no known cases of L. micdadei as the only causative organism. We report a case of a patient with a lung abscess from which L. micdadei was the sole organism isolated.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
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