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[Fatal legionellosis in an infant treated with ACTH]
C Lefrançois1, I Casadevall, P Betremieux
1Unité de Réanimation Pédiatrique, Hôpital Pontchaillou, Rennes.
Archives Francaises De Pediatrie
|October 1, 1989
Abstract:
A new case of fatal systemic legionnaires' disease is reported in an infant. This 8 month-old boy was given a protracted treatment with adrenocorticotropic hormones for infantile spasms. Legionella pneumophila type I was found in tracheal secretions and there was multivisceral involvement at autopsy. The mode of contamination and the severity of the disease are discussed in the light of the immunosuppressive properties of the glucocorticoids administered over a period of 4 weeks.
Insights
A fatal case of Legionnaires
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Infantile spasms are often treated with adrenocorticotropic hormones.
- Glucocorticoids can suppress the immune system.
- Legionella pneumophila is a bacterium that causes Legionnaires' disease.
Observation:
- An 8-month-old boy with infantile spasms received a 4-week course of adrenocorticotropic hormones.
- The infant developed a fatal systemic Legionnaires' disease.
- Legionella pneumophila type I was identified in tracheal secretions.
Findings:
- Autopsy revealed multivisceral involvement.
- The infant's immunosuppression from glucocorticoids likely contributed to disease severity.
- The specific mode of contamination remains undetermined.
Implications:
- This case highlights the risk of severe Legionnaires' disease in infants treated with immunosuppressive glucocorticoids.
- Physicians should consider Legionella exposure in febrile infants with respiratory symptoms, especially those on immunosuppressants.
- Further research is needed to understand the interplay between glucocorticoid therapy and Legionella infection in pediatric populations.