Relapsing Legionella pneumophila cellulitis: a case report and review of the literature

Han, Jennifer H.; Nguyen, Josephine; Harada, Shuko; Baddour, Larry M.; Edelstein, Paul H.

doi:10.1007/s10156-010-0072-6

Cited by 16 publications

(25 citation statements)

References 14 publications

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“…We identified 19 additional reports of cutaneous legionellosis ([ n = 20] 12 confirmed; 7 possible). Table summarizes the treatment of the 13 patients with confirmed cutaneous legionellosis (, and the current report [CR]); Table summarizes treatment of the 7 with possible cutaneous legionellosis.…”

Section: Resultsmentioning

confidence: 99%

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Cutaneous legionellosis: case report and review of the medical literature

Padrnos

Blair

Kusne

et al. 2014

Transplant Infectious Dis

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Discrete nodules developed on the leg of a 27-year-old immunosuppressed woman after an allogeneic stem cell transplant. Biopsy and culture grew Legionella pneumophila serogroup 8. On day 7 of azithromycin treatment, respiratory distress and abnormal liver transaminases developed, and the patient died on day 14. Review of the medical literature identified 19 reports of Legionella species-associated skin or soft tissue infections (total of 20 patients, 13 with confirmed infection). Manifestations of the 13 confirmed cases included erythematous macular rash (n = 7), erythema after thoracentesis (n = 1), abscess formation (n = 4), respiratory symptoms (n = 6), and abnormal chest radiographs (n = 8). Six required surgical exploration and débridement, and 7 were immunocompromised. Rash and respiratory infection improved with antibiotics in 10, but 3 died. Immunosuppression may predispose transplant recipients to Legionella infections. Diagnostic biopsies may facilitate appropriate treatment.

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Section: Resultsmentioning

confidence: 99%

“…The skin manifestations of cutaneous Legionella infection are varied and include erythematous macular , nodular (, CR), and vesicular eruptions. One patient had rapidly expanding erythema after thoracentesis .…”

Section: Resultsmentioning

confidence: 99%

Cutaneous legionellosis: case report and review of the medical literature

Padrnos

Blair

Kusne

et al. 2014

Transplant Infectious Dis

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“…The increase in antibody titers for L. longbeachae was interpreted as cross reactivity as several separate PCR analyses specifically and repeatedly identified L. bozemanii from wound tissue. In this case, these findings were considered relevant due to a majority of Legionella soft tissue infections being reported in patients with ongoing immune suppression (2–9). …”

Section: Discussionmentioning

confidence: 91%

“…The symptoms include flulike illness, with fever, headache, and myalgia (1). There are reports of skin and soft tissue infections caused by Legionella spp ., including both L. pneumophila and other species, but these infections are rare and often appear in immunocompromised patients (2–9). Legionella species are found primarily in aqueous environments and in soil (10, 11), and thrive in artificial water and ventilation systems, which can disperse the bacteria causing outbreaks (12).…”

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confidence: 99%

Soft tissue infection caused byLegionella bozemaniiin a patient with ongoing immunosuppressive treatment

Neiderud

Vidh

Salaneck

2013

Infection Ecology & Epidemiology

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The Legionellaceae family consists of approximately 50 species, of which the most commonly identified species is L. pneumophila, the causative agent of Legionnaires’ disease. Other Legionella ssp. most often cause clinical infections in the immune-compromised patients, in which L. bozemanii has been known to cause both pneumonia and lung abscesses. In the presented case, a soft tissue infection in a patient with ongoing immunosuppression was determined to be due to L. bozemanii. Hence, in immune-deficient patients, L. bozemanii could be considered a possible agent in soft tissue infections when other common pathogens have been ruled out.

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“…Since the index of suspicion is low, these infections can easily be overlooked. Legionella species have been implicated in cases of sinusitis [74], cellulitis [75], pancreatitis [76], brain abscess [72], acalculous cholecystitis [77] and myositis [76]. Typically, extrapulmonary infections occur concurrently with pneumonia and are believed to result from bacteremia [73].…”

Section: Extrapulmonary Diseasesmentioning

confidence: 99%

Nosocomial Legionnaires’ Disease: Risque and Prevention

Tai¹,

Benchekroun²,

Ennaji³

et al. 2012

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In 1977, Fraser et al. described an outbreak of pneumonia among legionnaires attending a convention at a hotel in Philadelphia in 1976. Legionnaires' disease (LD) can be nosocomial, community acquired or travel related. The incidence of hospital-acquired legionellosis appears to be increasing. Colonization of water systems by Legionella spp. is ubiquitous in hospitals throughout the world. The outbreak, which later became known as legionnaires' disease, was caused by a new pleomorphic, faintly staining gram-negative bacillus, L. pneumophila, which was isolated at the Center for Disease Control from lung tissues of legionnaires who died. Risk assessment for this disease forms the basis for the institution of control measures. Detection and quantification of Legionella spp. in the environment, in particular in the hospital water distribution system is one of the cornerstones of risk assessment. This review summarizes the current state-of-the-art regarding these aspects and points out important areas which require further study. The environmental surveillance revealed that the centralized hot water distribution system of the hospital was colonized with Legionella. Methods of prevention of the organisms for eradication involved in hospital water systems.

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Relapsing Legionella pneumophila cellulitis: a case report and review of the literature

Cited by 16 publications

References 14 publications

Cutaneous legionellosis: case report and review of the medical literature

Cutaneous legionellosis: case report and review of the medical literature

Soft tissue infection caused byLegionella bozemaniiin a patient with ongoing immunosuppressive treatment

Nosocomial Legionnaires’ Disease: Risque and Prevention

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