Myocarditis: a rare complication during Legionella infection

Armengol, S.; Domingo, Ch.; Mesalles, E.

doi:10.1016/0167-5273(92)90276-9

Cited by 21 publications

(11 citation statements)

References 5 publications

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“…In an immunocompetent patient, community-acquired pneumonia is caused by L. longbeachae (Diederen et al, 2005). Numerous cases have been reported related to L. pneumophila and non-L. pneumophila infection around the world, such as perimyocarditis (Burke et al, 2009), community-acquired lung abscess (Girard and Gregson, 2007), legionella endocarditis (Massey et al, 2003), rheumatoid arthritis (Chang et al, 2001), chronic lymphocytic leukemia (Hendrick, 2001;Siegel et al, 2010;Thacker et al, 1992), Myocarditis (Armengol et al, 1992), cancer (Jacobson et al, 2008) and invasive aspergillosis (Saijo et al, 2008). However, the case of malignant melanoma patients complicating pneumonia of L. pneumophila Sg 1 infection had not been reported before.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, many methods for detection of Legionella appear. These methods include urine antigen detection, direct fluorescent antibody (DFA) and sequence-based genotypic classification scheme such as PCR and real-time PCR (Armengol et al, 1992;Cloud et al, 2000;Massey et al, 2003;Thacker et al, 1992). Most commercially available assays based on PCR target species-specific regions within the 16S and 5S rRNA genes as well as in the mip gene.…”

Section: Introductionmentioning

confidence: 99%

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A case of malignant melanoma patient complicating pneumonia of Legionella pneumophila Sg 1 infection and means to detect Legionella from the patient

Hui¹,

Rong²,

Ming³

et al. 2013

Afr. J. Microbiol. Res.

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Legionella pneumonia is mainly caused by the inhalation of Legionella contaminated aerosol, aspiration or wound infection. Patients undergoing a severe immunosuppressive therapy such as organ transplant or cancer therapy are particularly at risk of infection. This study reported a case of Legionella pneumonia caused by Legionella pneumophila in a man with malignant melanoma. The method for diagnosing Legionella pneumonia by standard culture method was elaborate. A rapid diagnostic method derived from a two-step scheme assay with 99.42% accuracy for identification and differentiation of L. pneumophila and non-L. pneumophila in environmental Legionella isolates were also utilized in this study to evaluate whether this method was available for diagnosing Legionella infection. To confirm the diagnosis result of this rapid diagnostic method, sequencing of the bacteria in patient's sputum partial gene was also carried out. The diagnosis result of this rapid diagnostic method was consistent with the culture method which indicated that it was effective in diagnosing L. pneumophila infection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A case of malignant melanoma patient complicating pneumonia of Legionella pneumophila Sg 1 infection and means to detect Legionella from the patient

Hui¹,

Rong²,

Ming³

et al. 2013

Afr. J. Microbiol. Res.

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“…We analyzed the 7 that were accessible and in English (Table I). [2][3][4][5][10][11][12] Five cases were reported as myocarditis, [3][4][5]10,11 one as perimyocarditis, 12 and one as pericarditis. 2 Half the patients who had acute LV dysfunction during presentation still had LV dysfunction after appropriate therapy.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Reported arrhythmias include bradycardia, tachycardia, and conduction abnormalities. [3][4][5] The severity of the illness depends on the organ systems involved; it is typically severe with cardiac involvement, especially in myocarditis.…”

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confidence: 99%

TandemHeart as a Bridge to Recovery in Legionella Myocarditis

Briceño

Fernando

Nathan³

et al. 2015

Texas Heart Institute Journal

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L egionnaires' disease is the designation for pneumonia caused by the Legionella species. In addition to its pulmonary involvement, Legionella has been isolated in the heart, brain, lymph nodes, spleen, liver, and kidneys in autopsy studies. Extrapulmonary manifestations are rare; of these, cardiac involvement is most prevalent, in the forms of myocarditis, pericarditis, postcardiotomy syndrome, and prosthetic valve endocarditis.1,2 Reported arrhythmias include bradycardia, tachycardia, and conduction abnormalities.3-5 The severity of the illness depends on the organ systems involved; it is typically severe with cardiac involvement, especially in myocarditis.We report the case of a patient who had Legionella myocarditis associated with acute left ventricular (LV) dysfunction and repolarization abnormalities, and we describe his treatment with use of a TandemHeart ® percutaneous ventricular assist device (pVAD) (CardiacAssist, Inc.; Pittsburgh, Pa). In addition, we review the medical literature on Legionella myocarditis and focus on cardiac outcomes. Case ReportIn April 2013, a 48-year-old previously healthy man presented at a hospital with a 10-day history of cough, subjective fever, chills, myalgias, and generalized body aches. He was instructed to take oral antibiotics. However, he was readmitted the same night with worsening dyspnea, headaches, and hypoxemic respiratory failure that necessitated intubation. A chest radiograph and computed tomographic scans of the chest revealed extensive multilobar alveolar consolidation within the right lung (Fig. 1). Legionella infection was diagnosed on the basis of a positive urine antigen test. All other microbiological tests were negative, including bronchoalveolar lavage (gram stain, bacterial and viral cultures, and acid-fast bacilli) and Streptococcus pneumoniae urine antigen. Multiple viral studies were also negative: human immunodeficiency virus, parvovirus, Coxsackievirus A and B, influenza, and herpes simplex virus 1 and 2. Despite broad-spectrum antibiotic therapy that included levofloxacin and azithromycin, the patient's condition rapidly deteriorated, and his clinical course was complicated by acute renal and heart failure. A transthoracic echocardiogram (TTE) revealed dilated cardiomyopathy with severely depressed LV systolic function and severe mitral regurgitation. The patient's LV internal dimensions in systole and diastole were 4.8 cm and 5.8 cm, respectively. The estimated LV ejection fraction (LVEF) was 0.10. Cardiac biomarkers were noted to be positive. The patient then developed atrial flutter with variable atrioventricular block ( Fig. 2A), followed by

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“…团菌在澳大利亚感染者中最为常见 [3] 。临床分离的军团菌种，除了嗜肺军团菌，至少有 20 军团菌种可引起人类致病，但是发病率很低 [4,5] 。军团菌肺炎的临床特征各不相同，早期的症状是发热、萎靡、肌痛、厌食、头痛、咳嗽等症状。重症军团菌肺炎发热可达 40℃，出现昏迷，并可发展成为多器官衰竭 [6] [19] 。长滩军团菌感染引起的社区获得性军团菌病，病人的免疫力活性并没有降低 [20] 。在全球范围内与嗜肺军团菌和非嗜肺军团菌感染相关的病例报告，有如心包心肌炎 [21] ，社区获得性肺脓肿 [22] ，军团菌感染性心内膜炎 [23] ，风湿性关节炎 [24] ，慢性淋巴细胞性白血病 [25，26，27] ，心肌炎 [28] ，癌症 [29] , 侵袭性曲霉菌病 [30] …”

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恶性黑色素瘤合并嗜肺军团菌感染性肺炎病例报告

Zhu

Qiu

2014

国际临床报告

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Legionella pneumonia is mainly in community-acquired and nosocomial pneumonias caused by the L. pneumophila. The paper reported a case of Legionella pneumonia caused by Legionella pneumophila Sg1 in a man with malignant melanoma. The method for diagnosing Legionella pneumonia by standard cult ，， ure method serotyping PCR-enzymatic digestion analysis and gene sequencing was elaborate. To confirm the diagnosis result of this rapid diagnostic method, sequencing of the bacteria in patient's sputum partial gene was also carried out. The diagnosis result of this rapid diagnostic method was consistent with the culture method which indicated that it was effective in diagnosing L. pneumophila infection. Key words

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Myocarditis: a rare complication during Legionella infection

Cited by 21 publications

References 5 publications

A case of malignant melanoma patient complicating pneumonia of Legionella pneumophila Sg 1 infection and means to detect Legionella from the patient

A case of malignant melanoma patient complicating pneumonia of Legionella pneumophila Sg 1 infection and means to detect Legionella from the patient

TandemHeart as a Bridge to Recovery in Legionella Myocarditis

恶性黑色素瘤合并嗜肺军团菌感染性肺炎病例报告

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