Cutaneous legionellosis: case report and review of the medical literature. Issue 2 (17th March 2014)

• Record Type: Journal Article
• Authors: Padrnos, L.J.; Blair, J.E.; Kusne, S.; DiCaudo, D.J.; Mikhael, J.R.
• Is Part Of: Transplant infectious disease. Volume 16:Issue 2(2014)
• Page Start: 307
• Page End: 314
• Publication Date: 2014-03-17
• Subjects: Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12201
• Languages: English
• ISSNs: 1398-2273

Abstract

<abstract abstract-type="main" id="tid12201-abs-0001"> <title>Abstract</title> <p>Discrete nodules developed on the leg of a 27‐year‐old immunosuppressed woman after an allogeneic stem cell transplant. Biopsy and culture grew <italic>Legionella pneumophila</italic> serogroup 8. On day 7 of azithromycin treatment, respiratory distress and abnormal liver transaminases developed, and the patient died on day 14. Review of the medical literature identified 19 reports of <italic>Legionella</italic> species‐associated skin or soft tissue infections (total of 20 patients, 13 with confirmed infection). Manifestations of the 13 confirmed cases included erythematous macular rash (<italic>n</italic> = 7), erythema after thoracentesis (<italic>n</italic> = 1), abscess formation (<italic>n</italic> = 4), respiratory symptoms (<italic>n</italic> = 6), and abnormal chest radiographs (<italic>n</italic> = 8). Six required surgical exploration and débridement, and 7 were immunocompromised. Rash and respiratory infection improved with antibiotics in 10, but 3 died. Immunosuppression may predispose transplant recipients to <italic>Legionella</italic> infections. Diagnostic biopsies may facilitate appropriate treatment.</p> </abstract>