1/216. Legionella pneumonia from a novel industrial aerosol.After a worker from a plastics factory was diagnosed with legionella pneumonia it was learnt that a retired employee at the factory had been in hospital with a serious chest infection six months before and legionella pneumonia was diagnosed in retrospect from stored serum. The likeliest common source was a machine cooling system that took water from an uncovered water tank outdoors (from which legionella pneumophila was isolated) and which generated an aerosol through a crack in the flow meter sight glass.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
2/216. Acid-fast-positive legionella pneumophila: a possible pitfall in the cytologic diagnosis of mycobacterial infection in pulmonary specimens.The acid-fast stain is commonly used in the rapid cytologic assessment of bronchoalveolar lavage (BAL) fluid to detect pulmonary mycobacterial infections, particularly in immunocompromised patients. The identification of acid-fast, rod-shaped organisms may be taken as presumptive evidence of such an infection, in the appropriate clinical setting. However, this determination is made less specific by the occasional acid-fast positivity of microorganisms other than mycobacteria. We report on the occurrence of a fatal pneumonia caused by acid-fast positive legionella pneumophila detected by BAL. This is a potential pitfall in the rapid diagnosis of pulmonary mycobacterial infections.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
3/216. Detection of Legionella dna in peripheral leukocytes, serum, and urine from a patient with pneumonia caused by Legionella dumoffii.The polymerase chain reaction (PCR) has been used to detect Legionella dna in respiratory tract, serum, and urine samples from patients with pneumonia. In addition, a preliminary study using a guinea pig model suggested that testing of peripheral leukocytes by PCR may be more sensitive than testing of other samples. We used PCR to detect Legionella dna in serial peripheral leukocyte (buffy coat), serum, and urine samples from a patient with pneumonia caused by Legionella dumoffii. Legionella dna was detected in all 3 sample types when first collected. Buffy coat and urine samples remained positive up to 56 days after the onset of symptoms, whereas serum samples were positive from 10 up to 16 days after the onset of symptoms. Sequencing of PCR amplicons indicated the presence of L. dumoffii dna in positive samples. It appears that buffy coat may be a useful sample to test for Legionella dna, but further study is required to determine the precise sensitivity and to make comparisons with other sample types.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
4/216. Epstein-Barr virus-associated Hodgkin's lymphoma and legionella pneumophila infection complicating treatment of juvenile rheumatoid arthritis with methotrexate and cyclosporine A.We describe the case of a 53-month-old girl with juvenile rheumatoid arthritis (JRA), complicated by the occurrence of Hodgkin's lymphoma and legionella pneumophila infection during immunosuppressive treatment with methotrexate (MTX) and cyclosporine A (CSA). The girl had received variable anti-inflammatory combination therapy, including MTX for 28 months and CSA for 3 months. Thirty-six months after the onset of arthritis, the girl presented with an enlargement of the lymph nodes of the mediastinum, the hilum of the lungs, and the abdomen. Concomitantly, a diagnosis of Legionella pneumonia was rendered. autopsy showed Epstein-Barr virus (EBV)-associated nodular sclerosing Hodgkin's lymphoma. The neoplastic cells were positive for CD15, CD 30, and latent membrane protein 1 (LMP 1). The present case is the second reported to occur in a child, and it lends support to the hypothesis that immunosuppressive treatment may contribute to an increased risk of the development of EBV-associated lymphoproliferative disorders (LPD) in pediatric patients suffering from JRA.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
5/216. Tubulointerstitial nephritis associated with legionnaires' disease.A 47-year-old man was admitted to our hospital for community-acquired pneumonia complicated with acute renal failure. legionella pneumophila serogroup type 1 was grown in BCYE (buffered charcoal yeast extract) agar for sputum culture. Although his respiratory illness responded to intravenous erythromycin therapy, renal failure worsened and necessitated hemodialysis. Renal biopsy showed profound tubulointerstitial nephritis. After initiation of steroid therapy his renal function improved and he was discharged thereafter. These findings suggest that in legionnaires' disease with acute renal failure, tubulointerstitial nephritis should also be considered and steroid therapy may be an effective modality for the renal complication.- - - - - - - - - - ranking = 0.16727754246862keywords = pneumonia, interstitial (Clic here for more details about this article) |
6/216. Legionnaire's disease complicating pregnancy: a case report with intrauterine fetal demise.OBJECTIVE: Legionnaire's disease complicating pregnancy is an unusual event that can seriously compromise both the mother and the fetus. CASE REPORT: We describe one case of such association, with an unfavourable intrauterine fetal outcome, secondary to acute placental insufficiency, related to infection. DISCUSSION: It is important in these high risk pregnancies complicated by acute pneumonia to take into consideration the diagnosis, as early as possible, and the appropriate treatment or the careful monitoring of fetal wellbeing.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
7/216. diagnosis by polymerase chain reaction of pneumonia caused by legionella pneumophila in an immunocompetent child.A 10-year-old, previously healthy child with pneumonia caused by legionella pneumophila diagnosed by polymerase chain reaction (PCR) of serum is presented. Diagnostic methods were PCR of serum using two different primer sets, and the detection of specific antibody in paired sera using an indirect immunofluorescence assay. Legionella dna was amplified from serum obtained before and on day 6, but not after completion of a 14-day course of oral clarithromycin.The etiologic role of L. pneumophila was confirmed by seroconversion.The report illustrates that L. pneumophila PCR of serum may contribute to the identification of this microorganism as a cause of severe pneumonia in immunocompetent children.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
8/216. Failure to produce detectable antibodies to legionella pneumophila by an immunocompetent adult.A case of legionella pneumonia diagnosed by co-culture with amoebae and urinary antigen detection is described. Diagnostic antibody tests remained negative despite prolonged follow-up. Investigation showed no evidence of an under-lying immunodeficiency. The value of culture-based diagnosis and consequences of missed diagnoses are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
9/216. Persistent Legionella infection in a patient after bone marrow transplantation.We report on a patient who developed Legionella pneumonia after bone marrow transplantation. Despite appropriate antibiotic treatment, disease progressed. The patient developed a lung abscess from which Legionella and prevotella were isolated. Cure was achieved by surgical resection. The resected material was sterile, but 16S ribosomal dna analysis revealed Legionella dna.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
10/216. Acute pancreatitis caused by severe legionella pneumophila infection.We report three cases of severe community-acquired legionella pneumophila pneumonia with acute pancreatitis. pancreas involvement is unusual. The clinical presentations consisted of painless pancreatitis with only elevation of serum pancreatic enzymes (case 1), tender abdomen with edematous pancreas on computed tomography scan (case 2) and necrosis (case 3). We discuss the possible mechanisms of L. pneumophila associated acute pancreatitis for which the pathophysiology is still undetermined: infection, toxin release or cytokine secretion.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
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