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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.