Septic shock due to co-infection with Legionella pneumophila and Saprochaete clavata

Abstract

Septic shock is the most dreaded presentation of an infection, carrying a reserved prognosis. Appropriate antimicrobial therapy is therefore the mainstay of treatment, alongside organ support as needed. Legionnaires’ disease is mainly due to Legionella pneumophila serogroup 1 but it can be caused by other serogroups and species not detected by the urinary antigen test. Anti-tumour necrosis factor α therapy may increase the risk of invasive fungal infection, which carry a poor prognosis. We present a challenging case of a septic shock due to Legionella pneumophila and Saprochaete clavata infections, with a review of the two infections presented.

Invasive fungal disease presenting as septic shock in immunocompromised pediatric and adult patients: summary of reported cases

“…Only two of them survived the infection. IFD-related non-Candida septic shock was reported also in 28 adults (Table II) [21,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Among them, high mortality has been observed, with only 5/28 (17.9%) patients survival.…”

Metagenomic next-generation sequencing reveals co-infection with Legionella pneumophila and Fusobacterium necrophorum in a patient with severe pneumonia: a case report

“… Gender Age Country Coinfection with pathogens Diagnostic Tool of Legionnaires’ Disease Outcomes Ref. 1 F > 65 England SARS-CoV-2 Urine Ag Expired Chalker, V.J., et al [ 8 ] 2 F > 80 England SARS-CoV-2 Urine Ag Expired Chalker, V.J., et al 9 3 M 80 Japan SARS-CoV-2 Urine Ag Expired Arashiro, T., et al [ 9 ] 4 M 59 Italy Klebsiella pneumoniae real-time PCR Expired Scaturro, M., et al [ 10 ] 5 F 43 Portugal Saprochaete clavata PCR Expired Caldas, J.P., et al [ 12 ] 6 F 40 China Pneumocystis jirovecii mNGS Expired Oggioni, C., et al [ 14 ] 7 F 80 Caucasian …”

Disseminated fungal disease caused by Magnusiomyces clavatus in a pediatric cancer patient: Case report and review of the literature

“…Most cases have occurred in France and Italy with occasional reports elsewhere in Eastern Europe, the Middle East, China, and South America. [10][11][12] Case series have identified hematologic malignancy, chemotherapy, neutropenia, broadspectrum antimicrobials, and central venous catheters as risk factors for infection. 9,10 Chemotherapeutics that alter gut mucosa may lead to increased gut translocation associated with M. clavatus infection.…”