Community‐acquired Legionnaires' disease in a renal transplant recipient with unclear incubation period: the importance of molecular typing

Abstract

Transplant recipients are at risk of developing Legionnaires' disease (LD) because of impaired cellular immunity. Here, we describe a renal transplant recipient who developed LD at least 10 days after hospital admission and transplantation. The hospital water network was initially suspected, but further testing determined that the probable source was the patient's domestic water supply. Our report also suggests that the patient's immunosuppressed state may have switched potential colonization to pneumonia.

Case Report: First Report of Fatal Legionella pneumophila and Klebsiella pneumoniae Coinfection in a Kidney Transplant Recipient

“…Although rarely observed, longer incubation periods are actually possible as already documented, mainly in immune-compromised patients ( 21 ). For this reason, according to the CDC case definition, also at the European level, the incubation period should be extended to 14 days ( 18 ).…”

The relevance of molecular genotyping to allocate cases in a suspected outbreak of Legionella pneumonia in patients with prolonged immunosuppressive therapy

“…The greater diagnostic capability, variety of possible sources of contagion, higher numbers of at-risk persons, travelling habits, and influence of climate change are possible explanations for this increase (Walker, 2018). The connection with the environmental source is conducted on the basis of the incubation period (2-10 days), although longer periods have been described (Bargellini et al, 2013;Cassier et al, 2015).…”