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Legionella pneumophila aortitis in a heart transplant recipient
1Service of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Abstract:
We describe the case of a patient with a culture-proven infection of the ascending aorta caused by Legionella pneumophila 16 months after cardiac transplantation. Serology follow-up and surveillance culture of the hospital water supply suggested a nosocomial acquisition of the infection during the post-transplantation period. The diagnosis was made after 5 months of recurrent unexplained febrile episodes. A Teflon ring implanted around the aortic suture line during the intervention may have contributed to the unusual localization of the infection. The patient was successfully treated with antibiotics and aortic reconstruction.
Insights
A rare case of Legionella pneumophila infection in the ascending aorta occurred 16 months post-cardiac transplant. This nosocomial infection, possibly linked to a Teflon ring, was successfully treated with antibiotics and surgery.
Area of Science:
- Infectious Diseases
- Cardiology
- Transplantation Immunology
Background:
- Cardiac transplantation is a life-saving procedure for end-stage heart failure.
- Post-transplant infections pose a significant risk to patient outcomes.
- Legionella pneumophila is an opportunistic pathogen typically causing pneumonia.
Observation:
- A patient developed a culture-proven ascending aortic infection due to Legionella pneumophila 16 months after cardiac transplantation.
- Recurrent unexplained febrile episodes lasting 5 months preceded the diagnosis.
- Surveillance of the hospital water supply indicated potential nosocomial acquisition during the post-transplant period.
Findings:
- The unusual localization of Legionella pneumophila in the ascending aorta may have been influenced by a Teflon ring used during aortic suture line repair.
- Diagnosis was challenging due to the atypical presentation and delayed onset.
- Successful treatment involved a combination of antibiotics and aortic reconstruction.
Implications:
- This case highlights the potential for atypical and late-onset infections following cardiac transplantation.
- It underscores the importance of considering unusual pathogens and infection sites in immunocompromised patients.
- Findings suggest a need for vigilance regarding nosocomial infections, including Legionella, in transplant recipients and potential environmental sources.
