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Related Experiment Videos

Bilateral pleuritis caused by Legionella micdadei.

Y Takiguchi1, M Nakamura, N Aotsuka

  • 1Department of Internal Medicine, Chiba Municipal Hospital.

Internal Medicine (Tokyo, Japan)
|June 11, 1999
PubMed
Summary

A patient with myasthenia gravis and thymoma developed Legionella micdadei pleuritis. Despite intensive treatment, the immunosuppressed patient died, highlighting the need for clinical awareness of this rare infection.

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Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Oncology

Background:

  • A 58-year-old female patient with a history of myasthenia gravis and invasive thymoma presented with respiratory distress.
  • The patient had undergone thymectomy and received postoperative immunosuppressive therapy, including oral prednisolone and intrathoracic anti-cancer drugs.

Observation:

  • Chest radiography revealed bilateral pleural effusions.
  • Legionella micdadei was isolated from the pleural effusions, leading to a diagnosis of L. micdadei-induced pleuritis.

Findings:

  • The patient's condition deteriorated, and she died despite comprehensive medical interventions, including mechanical ventilation, chest tube drainage, and intravenous erythromycin.
  • This case represents a rare instance of Legionellosis caused by L. micdadei in Japan, with only two previous reports.

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Implications:

  • The case underscores the importance of considering L. micdadei as a potential pathogen in immunocompromised individuals presenting with respiratory infections.
  • Clinicians should maintain a high index of suspicion for rare bacterial infections in patients with underlying conditions affecting the immune system.