Lung abcess complicating Legionella micdadei pneumonia in an adult liver transplant recipient: case report and review

Transplantation. 1998 Jan 15;65(1):130-4. doi: 10.1097/00007890-199801150-00025.

Abstract

Legionella micdadei (Pittsburgh pneumonia agent) is the second most common cause of Legionella pneumonia, and occurs predominantly in immunocompromised hosts. L micdadei is the cause of nosocomial pneumonia in renal transplant recipients, but has not been described in other adult solid organ transplant recipients. This report describes the first case of L micdadei pneumonia in an adult liver transplant recipient on immunosuppressive therapy. Importantly, this case highlights the difficulties in establishing the diagnosis, as the Legionella urinary antigen is negative, and special culture conditions are required. Furthermore, this case illustrates several atypical clinical features of L micdadei pneumonia in a transplant recipient, including a community acquired mode of transmission, occurrence several years after organ transplantation, and lung abcess formation. The patient was successfully treated with limited surgical resection and quinolone antimicrobial monotherapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-Infective Agents / therapeutic use
  • Bronchoalveolar Lavage Fluid / microbiology
  • Ciprofloxacin / therapeutic use
  • Diabetes Mellitus, Type 2 / complications
  • Hepatitis B / complications
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Legionellosis / complications*
  • Liver Transplantation*
  • Lung Abscess / complications*
  • Male
  • Pneumonia, Bacterial / complications*
  • Postoperative Complications*
  • Tacrolimus / therapeutic use
  • Tomography, X-Ray Computed

Substances

  • Anti-Infective Agents
  • Immunosuppressive Agents
  • Ciprofloxacin
  • Tacrolimus