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[Childhood legionellosis]
A Ferrer1, R I Elcuaz, M Giménez-Pérez
1Servicios de Microbiología y Parasitología, Universidad Autónoma, Barcelona.
Insights
This study reports four pediatric hospital-acquired pneumonia cases caused by Legionella pneumophila serogroup 6. Three of the four immunocompromised children died, highlighting the severity of infantile legionellosis.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Hospital Epidemiology
Background:
- Legionella pneumophila is a recognized cause of pneumonia in adults, but less commonly reported in children.
- Hospital-acquired pneumonia (HAP) presents a significant challenge in pediatric care settings.
- Understanding the epidemiology and clinical presentation of specific pathogens in HAP is crucial for timely diagnosis and treatment.
Observation:
- Four pediatric patients aged 10 days to 7 years developed hospital-acquired pneumonia between 1987-1988.
- Legionella pneumophila serogroup 6 was identified in various respiratory samples, including pleural fluid and lung biopsy.
- All affected children had underlying immunological deficiencies, and three succumbed to the infection.
Findings:
- Legionella pneumophila serogroup 6 can cause severe, sporadic hospital-acquired pneumonia in immunocompromised children.
- Diagnosis was often delayed as Legionnaires' disease was not initially suspected.
- Erythromycin therapy was administered in only two cases due to the lack of early etiological suspicion.
Implications:
- This case series underscores the importance of considering Legionella in the differential diagnosis of HAP in pediatric patients, especially those who are immunocompromised.
- Early and accurate diagnosis of Legionnaires' disease in children is critical for appropriate antimicrobial therapy and improved outcomes.
- Further research is needed to elucidate the specific risk factors and optimal management strategies for infantile legionellosis in hospital settings.
Abstract:
Four cases of hospital acquired pneumonia are reported in children aged from 10 days to 7 years, in whom L. pneumophila serogroup 6 was isolated. All patients were sporadic cases occurring during a two year period (1987-1988) in the Pediatric Hospital of our institution. L. pneumophila was isolated in samples of pleural fluid, lung biopsy, tracheal aspirate, bronchial brushing and bronchoalveolar lavage. All our patients were immunologically depressed and three died. Only in two cases of erythromycin therapy was administered, as the etiology of their pneumonia was not suspected. The literature on other reported cases of infantile legionellosis is discussed.