1/4. 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 = antigen (Clic here for more details about this article) |
2/4. legionellosis in patients with hiv infection.During the five-year period 1984-1988 we received 192 specimens from 180 patients infected with the human immunodeficiency virus (hiv) for investigation of Legionella infection. The majority of specimens were bronchoalveolar lavage (BAL) fluids (84%), but tracheal suctions and lung tissue from autopsies were also examined. The diagnostic methods used were a direct immunofluorescence assay (DFA) for the detection of Legionella antigen, and culture on buffered charcoal yeast extract (BCYE-alpha) media. All specimens were also examined for the presence of other bacterial lung pathogens, and all BAL specimens additionally for pneumocystis carinii and mycobacteria. legionellosis was not found to be common among hiv-infected patients, as only six specimens (3%) from six patients were found positive by DFA, and no specimens were culture-positive for Legionella species. Dual infection with Legionella and P. carinii occurred in two patients. Clinical data of the six patients are presented, and currently used methods for diagnosing legionellosis are discussed.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/4. Legionella birminghamensis sp. nov. isolated from a cardiac transplant recipient.A Legionella-like organism, strain 1407-AL-H, was isolated from a transbronchial lung biopsy specimen from a cardiac transplant recipient undergoing immunosuppressive therapy. The strain grew on buffered charcoal-yeast extract agar (BCYE) but not on BCYE in the absence of cysteine, and it showed gas-liquid chromatographic fatty acid profiles that were predominantly branch chained. Strain 1407-AL-H was antigenically distinct in slide agglutination tests from the 23 Legionella species and 39 serogroups previously described. dna hybridization studies placed it in a new Legionella species, Legionella birminghamensis (ATCC 43702).- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/4. lung abcess complicating Legionella micdadei pneumonia in an adult liver transplant recipient: case report and review.Legionella micdadei (Pittsburgh pneumonia agent) is the second most common cause of Legionella pneumonia, and occurs predominantly in immunocompromised hosts. L micdadei is the cause of nosocomial pneumonia in renal transplant recipients, but has not been described in other adult solid organ transplant recipients. This report describes the first case of L micdadei pneumonia in an adult liver transplant recipient on immunosuppressive therapy. Importantly, this case highlights the difficulties in establishing the diagnosis, as the Legionella urinary antigen is negative, and special culture conditions are required. Furthermore, this case illustrates several atypical clinical features of L micdadei pneumonia in a transplant recipient, including a community acquired mode of transmission, occurrence several years after organ transplantation, and lung abcess formation. The patient was successfully treated with limited surgical resection and quinolone antimicrobial monotherapy.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |