Combined Legionella and Escherichia Coli Lung Infection after a Tsunami Disaster

Abstract

Pulmonary infection after a tsunami is often polymicrobial and tends to form chronic pyogenic lung disease, necrotizing pneumonia, and empyemas. We report a combined pulmonary infection of Legionella and multiple antibiotic-resistant Escherichia coli in a previously well 75-year-old woman following immersion in tsunami waters 1 km inland from the Pacific coastline following the Tohoku Region Pacific Coast Earthquake of 2011. She needed drainage several times and the long-term use of multiple antibiotics according to the type of bacteria found and antibiotic susceptibility. We should be mindful of infections caused by multiple pathogens in the environment in Japan as a consequence of a tsunami disaster.

<i>Escherichia coli</i> Pneumonia in Combination with Fungal Sinusitis and Meningitis in a Tsunami Survivor after the Great East Japan Earthquake

“…Tsunami-related aspiration pneumonia is common among tsunami victims (Allworth 2005;Chierakul et al 2005;Ebisawa et al 2011). People who survive the wave frequently aspirate not only water, but also solid and particulate matter.…”

“…People who survive the wave frequently aspirate not only water, but also solid and particulate matter. Pneumonia after the aspiration of water or after near-drowning is often polymicrobial, with causative agents including aeromonads, pseudomonads, streptococci, E. coli, and others (Kao et al 2005;Maegele et al 2006;Ebisawa et al 2011). In the patient discussed here, polymicrobial infection was supposed, but only E. coli was isolated from sputum culture and BAL fluid.…”

“…reported in patients with tsunami-associated aspiration pneumonia, and the isolated organisms often include drugresistant pathogens (Maegele et al 2006;Ebisawa et al 2011). In sputum cultures, E. coli may be isolated as a contaminant (Ruiz et al 2008).…”

“…Tsunami-related aspiration pneumonia is common in tsunami victims (Allworth 2005;Chierakul et al 2005;Ebisawa et al 2011). This pneumonia, typically the result of polymicrobial infection, takes the form of lobar pneumonia and often is accompanied by lung abscess (Allworth 2005;Kao et al 2005).…”

Infectious Diseases after the 2011 Great East Japan Earthquake

“…10 Elderly evacuees under unfavorable circumstances have an increased risk for developing pneumonia, and those who aspirate a small amount of the organism may develop legionellosis. Ebisawa et al 11 have reported pulmonary co-infection of Legionella and multiple antibiotic-resistant Escherichia coli in a previously healthy 75-year-old woman, as a result of immersion in tsunami waters 1 km inland from the Pacific coastline following the 2011 Great East Japan Earthquake. This patient required drainage several times and long-term use of multiple antibiotics according to the bacteria observed and an antibiotic susceptibility test.…”