Severe bilateral pleuropneumonia caused by Legionella sainthelensi: a case report
Open Access
- 17 September 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Infectious Diseases
- Vol. 21 (1), 1-5
- https://doi.org/10.1186/s12879-021-06651-1
Abstract
Legionella spp. are ubiquitous freshwater bacteria responsible for rare but potentially severe cases of Legionnaires’ disease (LD). Legionella sainthelensi is a non-pneumophila Legionella species that was first isolated in 1980 from water near Mt. St-Helens (USA). Although rare cases of LD caused by L. sainthelensi have been reported, very little data is available on this pathogen. We describe the first documented case of severe bilateral pleuropneumonia caused by L. sainthelensi. The patient was a 35-year-old woman with Sharp’s syndrome treated with long-term hydroxychloroquine and corticosteroids who was hospitalized for an infectious illness in a university hospital in Reunion Island (France). The patient’s clinical presentation was complicated at first (bilateral pneumonia, multiloculated pleural effusion, then bronchopleural fistula) but her clinical condition eventually improved with the reintroduction of macrolides (spiramycin) in intensive care unit. Etiological diagnosis was confirmed by PCR syndromic assay and culture on bronchoalveolar lavage. To date, only 14 documented cases of L. sainthelensi infection have been described worldwide. This pathogen is difficult to identify because it is not or poorly detected by urinary antigen and molecular methods (like PCR syndromic assays that primarily target L. pneumophila and that have only recently been deployed in microbiology laboratories). Pneumonia caused by L. sainthelensi is likely underdiagnosed as a result. Clinicians should consider the possibility of non-pneumophila Legionella infection in patients with a compatible clinical presentation when microbiological diagnostic tools targeted L. pneumophila tested negative.This publication has 18 references indexed in Scilit:
- Minimum inhibitory concentration (MIC) distribution among wild-type strains of Legionella pneumophila identifies a subpopulation with reduced susceptibility to macrolides owing to efflux pump genesInternational Journal of Antimicrobial Agents, 2017
- Legionnaires’ disease in Europe, 2011 to 2015Eurosurveillance, 2017
- Microbiological and Clinical Studies of Legionellosis in 33 Patients with CancerJournal of Clinical Microbiology, 2015
- Quinolones versus macrolides in the treatment of legionellosis: a systematic review and meta-analysisJournal of Antimicrobial Chemotherapy, 2014
- Legionnaires Disease and the Updated IDSA Guidelines for Community‐Acquired PneumoniaClinical Infectious Diseases, 2004
- Two Nursing Home Outbreaks of Respiratory Infection with Legionella sainthelensiJournal of the American Geriatrics Society, 1999
- Legionella sainthelensi serogroup 2 isolated from patients with pneumoniaResearch in Microbiology, 1990