1/13. 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 = water (Clic here for more details about this article) |
2/13. pseudomonas aeruginosa community-acquired pneumonia in previously healthy adults: case report and review of the literature.We report a case of rapidly fatal pseudomonas aeruginosa community-acquired pneumonia (CAP) in a previously healthy 67-year-old woman. Eleven published case reports of P. aeruginosa CAP in previously healthy adults are reviewed. According to our review, the mean age of affected patients is 45.3 years. Five patients described in the literature were smokers with a mean smoking history of 40 pack-years. The clinical presentation is nonspecific, and although the pneumonia can be rapidly fatal, only 33% of the patients who were reported died. However, mortality may be independent of treatment within the first 36 hours of presentation. Exposure to aerosols of contaminated water is a risk factor for P. aeruginosa CAP in this population. Pseudomonas CAP should be considered in the differential diagnosis for anyone with a smoking history who presents with rapidly progressive pneumonia. We discuss treatment recommendations that are based on evidence in the currently available literature on the subject.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
3/13. Hot tub-associated necrotizing pneumonia due to pseudomonas aeruginosa.We describe a case of severe necrotizing pneumonia due to community-acquired pseudomonas aeruginosa. Cultures of fluid obtained from the filter of the patient's hot tub grew the same P. aeruginosa strain as that grown from culture of the patient's sputum. Centers for disease Control and Prevention guidelines should be strictly followed for hot tub maintenance to prevent P. aeruginosa overgrowth: the range of free chlorine levels in the water should be kept at 1-3 mg/L, and the pH should be kept at 7.2-7.8.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
4/13. Severe community-acquired pneumonia and sepsis caused by burkholderia pseudomallei associated with flooding in puerto rico.burkholderia pseudomallei (melioidosis) is usually found in endemic areas of Southeast asia and Northern australia. However, a few cases of confirmed melioidosis indigenous to puerto rico and the americas have been reported previously. We describe the occurrence of a B. pseudomallei infection in a female with insulin-dependent diabetes mellitus exposed to flood waters in puerto rico. We conclude that B. pseudomallei should be considered a potential pathogen in high-risk patients with severe community-acquired pneumonia and sepsis in Puerto Rico especially in individuals exposed to flood waters during rainy seasons. A more thorough epidemiologic and microbiologic surveillance with environmental sampling may be warranted in the island.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
5/13. Leptospiral pneumonia.Severe leptospirosis rarely presents with primary pulmonary manifestations, without any associated jaundice or renal dysfunction. The authors report a nine-year-old boy who presented with complaints of abrupt onset of high fever; with myalgia, headache, and pain in right chest region, productive cough with hemoptysis and vomiting developing over the past 72 hours. Chest radiograph showed consolidation in the right upper lobe with air bronchogram. A history of contact with sewage water and presence of conjunctival suffusion in a child with pneumonia made us suspect leptospirosis. Following prompt initiation of parenteral penicillin therapy the child's complaints resolved over the next five days. Dri-Dot test to detect anti-Leptospira antibodies was positive. The diagnosis of leptospirosis was confirmed by a positive microagglutination test to leptospira interrogans serovar australis by a fourfold rise in antibody titer in paired sera collected during convalescence. leptospirosis presenting with pulmonary hemorrhage has been associated with significant mortality but it can be successfully treated with early clinical suspicion of alveolar hemorrhage and prompt therapy.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
6/13. Legionella pneumonia due to exposure to 24-hour bath water contaminated by legionella pneumophila serogroup-5.A 79-year-old man was admitted to hospital from his nursing home for treatment of pneumonia, but died 7 days after admission. Legionella pneumonia was diagnosed after isolation of legionella pneumophila serogroup-5 from sputum culture. The environment of the nursing home was investigated; only water specimens from the 24-hour bath were positive by culture for legionella pneumophila serogroup-5. Subsequent analysis by pulsed-field gel electrophoresis revealed an identical pattern in isolates from both sputum culture and 24 hour bath water culture. Among 123 inpatients and staff of the nursing home, 17 were found to be seropositive for legionella pneumophila serogroup-5.- - - - - - - - - - ranking = 3keywords = water (Clic here for more details about this article) |
7/13. Pulmonary cholera due to infection with a non-O1 vibrio cholerae strain.We present 2 cases of primary pulmonary non-O1 vibrio cholerae infection. We believe that these are the first documented cases of primary pulmonary infection due to this organism from a freshwater source.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
8/13. 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 = 1keywords = water (Clic here for more details about this article) |
9/13. 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 = 2keywords = water (Clic here for more details about this article) |
10/13. Epidemiologic investigation by macrorestriction analysis and by using monoclonal antibodies of nosocomial pneumonia caused by legionella pneumophila serogroup 10.A 67-year-old woman was hospitalized with an acute pneumonia of the left lower lobe. legionella pneumophila serogroup 10 was cultured from two sputum specimens taken on days 18 and 20 and was also detected by direct immunofluorescence assay by using a commercially available species-specific monoclonal antibody as well as serogroup 10-specific monoclonal antibodies. Antigenuria was detected in enzyme-linked immunosorbent assays by using serogroup 10-specific polyclonal and monoclonal antibodies. In the indirect immunofluorescence test rising antibody titers against serogroups 1, 4, 5, 8, 9, 10, 14, and 15 were found in serum, with the highest titers found against serogroups 8, 9, and 10. L. pneumophila serogroups 10 and 6 and a strain that reacted with serogroup 4 and 14 antisera were cultured from both central and peripheral hot water systems of the hospital. Macrorestriction analyses of the genomic DNAs by pulsed-field gel electrophoresis showed that the isolate from the patient was identical to the serogroup 10 strains from the hospital hot water system. In contrast, the genomic DNAs of 16 unrelated L. pneumophila serogroup 10 strains showed 12 different restriction patterns. Monoclonal antibody subtyping revealed only minor differences in L. pneumophila serogroup 10 strains isolated from different sources. In conclusion, macrorestriction analysis is a valuable tool for studying the molecular epidemiology of L. pneumophila serogroup 10.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
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