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Bell H, Chintalapati S, Patel P, Halim A, Kithas A, Schmalzle SA. Legionella longbeachae pneumonia: Case report and review of reported cases in non-endemic countries. IDCases 2021; 23:e01050. [PMID: 33511033 PMCID: PMC7817369 DOI: 10.1016/j.idcr.2021.e01050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 02/06/2023] Open
Abstract
Legionella longbeachae pneumonia is much less common than Legionella pneumophila pneumonia in most of the world and may evade timely diagnosis in settings that rely primarily on urine antigen testing, which detects Legionella pnuemophila serogroup 1 only. It is, however, widely recognized in Australia and New Zealand, where it is endemic and associated with exposure to compost and potting soils, rather than contaminated water systems as seen with L. pneumophila. L. longbeachae can cause a similar spectrum and severity of illness as L. pneumophila. Here we present a case of a 47-year-old man with L. longbeacheae necrotizing pneumonia following exposure to possibly contaminated soil from a wastewater treatment facility. Initial presentation included cough, chest pain, and dyspnea, and progressed to hypoxic respiratory failure, tension pneumothorax, and cardiac arrest. L. pneumophila urine antigen was negative, but bronchioalveolar lavage samples grew L. longbeachae on buffered charcoal yeast extract agar. A review of cases reported in the literature in non-endemic regions over a 20-year period identified 38 cases in Europe, 33 in Asia, and 8 in North America. Average age was 65, 65 % were male, and 35 % had potentially relevant environmental exposures. L. longbeachae should be considered in cases of severe community acquired pneumonia, particularly following a consistent environmental exposure or if initial testing for other pathogens is unrevealing. A thorough exposure history including questions about contact with potting soil or compost, and utilization of specialized agar for culture can both be key in identifying this pathogen.
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Affiliation(s)
- Harrison Bell
- University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD, 21201, United States
| | - Sai Chintalapati
- University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD, 21201, United States
| | - Preet Patel
- University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD, 21201, United States
| | - Ameer Halim
- University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD, 21201, United States
| | - Andrew Kithas
- University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD, 21201, United States
| | - Sarah A Schmalzle
- Institute of Human Virology, University of Maryland School of Medicine, 725 West Lombard Street, Baltimore, MD, 21201, United States.,University of Maryland School of Medicine, Department of Medicine, Division of Infectious Diseases, 655 West Baltimore Street, Baltimore, MD, 21201, United States
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Oda N, Taki T, Mitani R, Takata I. Legionella longbeachae pneumonia: A case report and literature review in Japan. J Infect Chemother 2021; 27:751-754. [PMID: 33402302 DOI: 10.1016/j.jiac.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/07/2020] [Accepted: 12/12/2020] [Indexed: 10/22/2022]
Abstract
Herein, we report the case of a 74-year-old man diagnosed with Legionella pneumonia detected by Loop-Mediated Isothermal Amplification (LAMP) method, which was suspected to have been transmitted from the potting soil. Legionella longbeachae was identified in the sputum culture. The patient was intubated and maintained on mechanical ventilation. Antimicrobial therapy with azithromycin was also administered. His symptoms were resolved and he was discharged after 26 days of hospitalization. Legionella longbeachae pneumonia rarely occurs in Japan, and published literature of Legionella longbeachae pneumonia cases in Japan was reviewed. Patients with severe pneumonia exposed to potting soils, but with negative urinary antigen test results, should be examined by LAMP method.
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Affiliation(s)
- Naohiro Oda
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan.
| | - Takahiro Taki
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan
| | - Reo Mitani
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan
| | - Ichiro Takata
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan
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