An unusual presentation of<i>Legionella</i>pneumonia in a returning traveller

Shorten, Robert J.; Norman, Jane E.; Sweeney, Louise C

doi:10.1136/bcr-2019-230130

Cited by 1 publication

(1 citation statement)

References 15 publications

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“…For example, a comparison of mNGS with traditional microbial diagnostic methods for diagnosing Aspergillus found that mNGS had an accuracy of 78.3%, owing chiefly to the difficulty of extracting nucleic acids from molds, but a specificity as high as 97.5% ( 20 ). A search of PubMed identified only six case reports describing patients with secondary invasive pulmonary Aspergillus infection after Legionella infection ( 21 – 26 ) ( Table 1 ). Of these six patients, one was diagnosed by autopsy, one by histopathology, and four by microbiological isolation and culture.…”

Section: Discussionmentioning

confidence: 99%

Early Detection of Legionella pneumophila and Aspergillus by mNGS in a Critically Ill Patient With Legionella Pneumonia After Extracorporeal Membrane Oxygenation Treatment: Case Report and Literature Review

Yue

et al. 2021

Front. Med.

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Legionella pneumophila can cause pneumonia, leading to severe acute respiratory distress syndrome (ARDS). Because of its harsh growth requirements, limited detection methods, and non-specific clinical manifestations, diagnosing Legionella pneumonia remains still challenging. Metagenomic next-generation sequencing (mNGS) technology has increased the rate of detection of Legionella. This study describes a patient who rapidly progressed to severe ARDS during the early stage of infection and was treated with extracorporeal membrane oxygenation (ECMO). Although his bronchoalveolar lavage fluid (BALF) was negative for infection and his serum was negative for anti-Legionella antibody, mNGS of his BALF and blood showed only the presence of Legionella pneumophila (blood mNGS reads 229, BALF reads 656). After antibiotic treatment and weaning from ECMO, however, he developed a secondary Aspergillus and Klebsiella pneumoniae infection as shown by mNGS. Mechanical ventilation and antibiotic treatment were effective. A search of PubMed showed few reports of secondary Aspergillus infections after Legionella infection. Severe pneumonia caused by any type of pathogenic bacteria may be followed by Aspergillus infection, sometimes during extremely early stages of infection. Patients with severe pneumonia caused by Legionella infection should undergo early screening for secondary infections using methods such as mNGS, enabling early and precise treatment, thereby simplifying the use of antibiotics and improving patient prognosis.

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Section: Discussionmentioning

confidence: 99%

Early Detection of Legionella pneumophila and Aspergillus by mNGS in a Critically Ill Patient With Legionella Pneumonia After Extracorporeal Membrane Oxygenation Treatment: Case Report and Literature Review

Yue

et al. 2021

Front. Med.

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show abstract

An unusual presentation ofLegionellapneumonia in a returning traveller

Cited by 1 publication

References 15 publications

Early Detection of Legionella pneumophila and Aspergillus by mNGS in a Critically Ill Patient With Legionella Pneumonia After Extracorporeal Membrane Oxygenation Treatment: Case Report and Literature Review

Early Detection of Legionella pneumophila and Aspergillus by mNGS in a Critically Ill Patient With Legionella Pneumonia After Extracorporeal Membrane Oxygenation Treatment: Case Report and Literature Review

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