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Follicular bronchiolitis associated with Legionella pneumophilia infection
T Masuda1, Y Ishikawa, Y Akasaka
1Department of Pathology, School of Medicine, Toho University, Tokyo, Japan. ide@med.toho-u.ac.jp
Insights
A fatal case of pneumonia in an infant was linked to follicular bronchiolitis. Legionella pneumophila was identified as the causative pathogen using advanced diagnostic methods.
Area of Science:
- Pediatric Pathology
- Infectious Diseases
- Respiratory Medicine
Background:
- Follicular bronchiolitis (FBB) is a rare lung condition that can cause severe respiratory symptoms.
- Infantile respiratory distress and stridor can be indicative of serious underlying pulmonary pathology.
Observation:
- An 8-month-old infant presented with acute respiratory distress and stridor, rapidly progressing to respiratory insufficiency and death.
- Autopsy revealed bilateral follicular bronchiolitis, prompting an investigation into potential infectious agents.
Findings:
- Diagnostic investigations focused on Legionella pneumophila, Pneumocystis carinii, and Mycobacterium tuberculosis.
- Both immunohistochemistry and polymerase chain reaction confirmed Legionella pneumophila as the sole detected pathogen.
Implications:
- This case highlights Legionella pneumophila as a potential cause of fatal pneumonia with follicular bronchiolitis in infants.
- Emphasizes the importance of considering specific pathogens in severe pediatric respiratory infections.
- Suggests the utility of advanced diagnostic techniques for identifying causative agents in critical cases.
Abstract:
An 8-month-old girl with respiratory distress and stridor was admitted to our hospital. Two days later, she died of respiratory insufficiency due to pneumonia. Autopsy confirmed the presence of follicular bronchiolitis (FBB) in both lungs. After consideration of her clinical course, we focused on three pathogens: Legionella pneumophilia, Pneumocystis carinii, and Mycobacterium tuberculosis. Only Legionella pneumophilia was detected by both immunohistochemistry and polymerase chain reaction.