1/6. Complicated nosocomial pneumonia due to legionella pneumophila in an immunocompromised child.An immunocompromised child developed necrotizing pneumonia with BAL cultures growing legionella pneumophila resistant to treatment, including erythromycin and rifampicin. ciprofloxacin and clarithromycin reversed the clinical course; their use as first-line drugs is justifiable and a high index of suspicion for the occurrence of legionellosis is warranted.- - - - - - - - - - ranking = 1keywords = legionellosis (Clic here for more details about this article) |
2/6. Severe community-acquired pneumonia due to legionella pneumophila Serogroup 6.legionella pneumophila is a common cause of sporadic community-acquired pneumonia, but culture-proven legionellosis is rarely diagnosed. There is no laboratory test for legionnaires' disease that can detect all patients with the disease. culture is the standard diagnostic method and should be initiated as soon as possible in suspected cases. We describe a rare case of community-acquired pneumonia caused by L. pneumophila serogroup 6. A 77-year-old man was admitted to a tertiary care hospital because of high fever, productive cough, and progressive dyspnea. Chest radiography showed bilateral pneumonia, which led to respiratory failure necessitating mechanical ventilatory support. Despite antibiotic therapy, his condition continued to deteriorate and acute renal failure also developed. urine was negative for L. pneumophila. culture of the sputum yielded L. pneumophila serogroup 6, although there was no elevation of the serum antibody titer. pneumonia resolved gradually and he was extubated after treatment with levofloxacin followed by erythromycin. L. pneumophila other than serogroup 1 should be included in the differential diagnosis of patients with suspected atypical community-acquired pneumonia.- - - - - - - - - - ranking = 1keywords = legionellosis (Clic here for more details about this article) |
3/6. Use of sequence-based typing for investigation of a case of nosocomial legionellosis.A fatal case of nosocomial legionellosis in a low prevalence region (Calgary, alberta, canada) prompted investigation into the source of infection. Hospital water systems contaminated with legionella pneumophila have been shown to pose a risk to compromised patients. Typing of an L. pneumophila serogroup 1 strain isolated from the patient using sequence-based typing (SBT) and amplified fragment length polymorphism (AFLP) analysis linked it to a persistent and widespread strain isolated from the hospital water system establishing a nosocomial mode of acquisition. Different SBT and AFLP patterns were determined for non-epidemiologically linked cases and isolates from different hospitals.- - - - - - - - - - ranking = 5keywords = legionellosis (Clic here for more details about this article) |
4/6. diagnosis of legionella pneumophila infection by polymerase chain reaction.We examined the application of the polymerase chain reaction (PCR) for the diagnosis of legionellosis. Eight intratracheal aspirates were collected from a patient with pneumonia caused by legionella pneumophila serogroup 2, and serial 10-fold dilutions of the samples were obtained. Two samples were positive for L. pneumophila by the direct fluorescent antibody (DFA) method down to a 10(-2) concentration, and one was positive down to a 10(-4) concentration. PCR was positive for all eight samples, and the sensitivity was greater than that of the DFA method. Only one of the eight samples yielded organisms in culture: the L. pneumophila serogroup 2 strain was isolated on buffered charcoal yeast extract alpha agar as an atypical white, papillate colony.- - - - - - - - - - ranking = 1keywords = legionellosis (Clic here for more details about this article) |
5/6. Analysis of legionella pneumophila strains associated with nosocomial pneumonia in a neonatal intensive care unit.A premature child received continuous mechanical ventilation in a neonatal intensive care unit. On day 10 of his life he developed pneumonia due to legionella pneumophila serogroup 1, monoclonal subtype Bellingham. The strain was cultured from a tracheal secretion taken on day 10 and detected by immunofluorescence using monoclonal antibodies on days 10, 12 and 17. Legionella pneumophila serogroups 1 and 6 (10(2)-4 x 10(4) cfu/l) were cultured from both central and peripheral hot water systems. Monoclonal antibody testing, macrorestriction analysis of the genomic dna using pulse-field electrophoresis, and electrophoretic alloenzyme typing showed the isolate from the child to be identical to the serogroup 1 strains from the hot water system. Four unrelated Legionella strains of the same monoclonal subgroup Bellingham were studied for comparison. Legionellae were also isolated from two other incubators, but no clinical or microbiological indications of legionellosis were found in the neonates hospitalised there. Serogroup 1 strains isolated from the patient and from the hot water system and serogroup 6 isolates from the hot water supply were able to multiply in cultured acanthamoeba castellanii cells and in guinea pigs. The serogroup 6 strain, although prevalent in the incubators, was not found in any of the clinical specimens by either culture of immunofluorescence.- - - - - - - - - - ranking = 1keywords = legionellosis (Clic here for more details about this article) |
6/6. Fatal legionella longbeachae infection following heart transplantation.A case of fatal legionella longbeachae infection following heart transplantation is described. Gram stains of respiratory secretions on day 17 posttransplant revealed leucocytes and gram-negative bacilli, but there was no growth on routine bacterial culture. legionella longbeachae serogroup 1 was isolated from respiratory specimens, blood, and postmortem lung tissue. legionella longbeachae is a common cause of legionellosis in australia, and infection has been associated with exposure to potting mixes. Specific culture for Legionella spp. should be performed for any patient who develops pneumonia following organ transplantation.- - - - - - - - - - ranking = 1keywords = legionellosis (Clic here for more details about this article) |