Abscess and empyema caused by Legionella micdadei

Halberstam, Meyer; Isenberg, Henry D.; Hilton, Eileen

doi:10.1128/jcm.30.2.512-513.1992

Cited by 22 publications

(3 citation statements)

References 6 publications

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“…Indeed, these bacteria are responsible for a significant percentage of both community-acquired and nosocomial pneumonias (23,40,63). Legionella infections are also manifest in other ways, including cases of pleurisy, endocarditis, pancreatitis, abscess, wound infection, colitis, peritonitis, pyelonephritis, and cellulitis (8,20,23,29,36,47). Finally, the flu-like illness known as Pontiac fever has been associated with increases in antibody titer to several Legionella species (22)(23)(24).…”

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confidence: 99%

Infection of macrophage-like cells by Legionella species that have not been associated with disease

1996

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We assessed the ability of Legionella species that have not been associated with disease to infect macrophagelike U937 cells. Two of fourteen species tested exhibited a 50% infective dose that was within 1 log unit of that of virulent L. pneumophila. Indeed, intracellular CFU of L. jamestowniensis and L. parisiensis increased 100-fold over a 72-h period. These data indicate that additional legionellae can flourish within phagocytes and therefore, can, if given the opportunity, cause disease.

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confidence: 99%

Infection of macrophage-like cells by Legionella species that have not been associated with disease

1996

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“…Legionella micdadei is the second most common cause of Legionnaires' disease and Pontiac fever (15,21,23). In addition, infection by this gram-negative organism can result in abscess formation and cellulitis (29,34). In contrast to Legionella pneumophila, the most common agent of legionellosis, L. micdadei infects only immunocompromised hosts (22,48).…”

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Characterization of a Legionella micdadei mip mutant

1995

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The pathogenesis of Legionella micdadei is dependent upon its ability to infect alveolar phagocytes. To better understand the basis of intracellular infection by this organism, we examined the importance of its Mip surface protein. In Legionella pneumophila, Mip promotes infection of both human macrophages and freshwater protozoa. Southern hybridization and immunoblot analyses demonstrated that mip sequences were present and expressed within a panel of virulent L. micdadei strains. Using allelic exchange mutagenesis, we then constructed an L. micdadei strain that completely and specifically lacked Mip. Although unimpaired in its ability to grow in bacteriologic media, this Mip mutant was defective in its capacity to infect U937 cells, a human macrophage-like cell line. Most significantly, the Mip ؊ organism displayed a 24-fold reduction in survivability immediately after its entry into the phagocyte. Similarly, the mutant was less able to parasitize Hartmannella amoebae. Taken together, these data argue that Mip specifically potentiates intracellular growth by L. micdadei.

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“…Other Legionella species include, among others, L. bozemanii , and L. micdadei [2]. These other species, much rarer than L. pneumophila , can also exceptionally cause pneumonia with pleural empyema, which seems to be overrepresented compared to L. pneumophila [19,20]. Mycoplasma pneumonia , another intracellular bacteria known to cause pneumonia, has also been reported a few times as the causative agent of pleural empyema[21].…”

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FatalLegionella pneumophilaserogroup 1 pleural empyema: A case report

Maillet

Bonnet

Billard-Pomarès

et al. 2019

WJCCM

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BACKGROUNDLegionella pneumophila (L. pneumophila) is a gram-negative intracellular bacillus composed of sixteen different serogroups. It is mostly known to cause pneumonia in individuals with known risk factors as immunocompromised status, tobacco use, chronic organ failure or age older than 50 years. Although parapneumonic pleural effusion is frequent in legionellosis, pleural empyema is very uncommon. In this study, we report a case of fatal pleural empyema caused by L. pneumophila serogroup 1 in an 81-year-old man with multiple risk factors.CASE SUMMARYAn 81-year-old man presented to the emergency with a 3 wk dyspnea, fever and left chest pain. His previous medical conditions were chronic lymphocytic leukemia, diabetes mellitus, chronic kidney failure, hypertension and hyperlipidemia, without tobacco use. Chest X-ray and comouted tomography-scan confirmed a large left pleural effusion, which puncture showed a citrine exudate with negative standard bacterial cultures. Despite intravenous cefotaxime antibiotherapy, patient’s worsening condition after 10 d led to thoracocentesis and evacuation of 2 liters of pus. The patient progressively developed severe hypoxemia and multiorgan failure occurred. The patient was treated by antibiotherapy with cefepime and amikacin and with adequate symptomatic shock treatment, but died of uncontrolled sepsis. The next day, cultures of the surgical pleural liquid samples yielded L. pneumophila serogroup 1, consistent with the diagnosis of pleural legionellosis.CONCLUSIONL. pneumophila should be considered in patients with multiple risk factors and undiagnosed pleural empyema unresponsive to conventional antibiotherapy.

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Abscess and empyema caused by Legionella micdadei

Cited by 22 publications

References 6 publications

Infection of macrophage-like cells by Legionella species that have not been associated with disease

Infection of macrophage-like cells by Legionella species that have not been associated with disease

Characterization of a Legionella micdadei mip mutant

FatalLegionella pneumophilaserogroup 1 pleural empyema: A case report

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