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Persistent Legionella infection in a patient after bone marrow transplantation

C Schindel1, U Siepmann, S Han

  • 1Institute of Medical Microbiology and Hygiene, Hochhaus am Augustusplatz, University of Mainz, 55101 Mainz, Germany. schindel@mail.uni-mainz.de

Journal of Clinical Microbiology
|November 4, 2000
PubMed

Insights

Legionella pneumonia after bone marrow transplant can be severe, even with antibiotics. Surgical resection of a lung abscess was curative, confirming Legionella infection via DNA analysis.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Transplantation Medicine

Background:

  • Bone marrow transplantation (BMT) is a complex procedure associated with significant risks of opportunistic infections.
  • Legionella pneumonia is a severe bacterial infection that can occur in immunocompromised individuals.

Observation:

  • A patient undergoing BMT developed progressive Legionella pneumonia despite standard antibiotic therapy.
  • The patient subsequently developed a lung abscess, indicating treatment failure and disease complication.

Findings:

  • The lung abscess yielded both Legionella and Prevotella species upon culture.
  • Surgical resection of the lung abscess resulted in a complete cure.
  • Post-resection analysis of the abscess tissue was sterile by culture but positive for Legionella DNA via 16S ribosomal DNA sequencing.

Implications:

  • This case highlights the potential for severe, refractory Legionella pneumonia post-BMT.
  • Surgical intervention may be a necessary treatment modality for complex lung abscesses in immunocompromised patients.
  • 16S ribosomal DNA analysis can be crucial for diagnosing infections when cultures are negative, especially in challenging cases.

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