Cutaneous legionellosis: case report and review of the medical literature | Zendy

Padrnos L.J. | Zendy; Blair J.E. | Zendy; Kusne S. | Zendy; DiCaudo D.J. | Zendy; Mikhael J.R. | Zendy

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Cutaneous legionellosis: case report and review of the medical literature

Author(s) -

Padrnos L.J.,

Blair J.E.,

Kusne S.,

DiCaudo D.J.,

Mikhael J.R.

Publication year - 2014

Publication title -

transplant infectious disease

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.69

H-Index - 67

eISSN - 1399-3062

pISSN - 1398-2273

DOI - 10.1111/tid.12201

Subject(s) - medicine , azithromycin , rash , thoracentesis , immunosuppression , legionella , dermatology , respiratory distress , surgery , antibiotics , pleural effusion , genetics , bacteria , microbiology and biotechnology , biology

Discrete nodules developed on the leg of a 27‐year‐old immunosuppressed woman after an allogeneic stem cell transplant. Biopsy and culture grew L egionella pneumophila serogroup 8. On day 7 of azithromycin treatment, respiratory distress and abnormal liver transaminases developed, and the patient died on day 14. Review of the medical literature identified 19 reports of L egionella species‐associated skin or soft tissue infections (total of 20 patients, 13 with confirmed infection). Manifestations of the 13 confirmed cases included erythematous macular rash ( n = 7), erythema after thoracentesis ( n = 1), abscess formation ( n = 4), respiratory symptoms ( n = 6), and abnormal chest radiographs ( n = 8). Six required surgical exploration and débridement, and 7 were immunocompromised. Rash and respiratory infection improved with antibiotics in 10, but 3 died. Immunosuppression may predispose transplant recipients to L egionella infections. Diagnostic biopsies may facilitate appropriate treatment.

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