Korean J Infect Dis.  1999 Aug;31(4):353-357.

A Case of Community-acquired Legionnaires' Disease in a Renal Transplant Recipient

• Seog W
• Jung YJ
• Park HW
• Lee HK
• Park MS
• Park MY
• Park KS
• Oh MD
• Ahn C
• Kim EC
• Choe KW

Abstract

Legionella species are causative agents of both community-acquired and nosocomial pneumonia. The spectrum of disease ranges from asymptomatic infection to serious disease and two specific syndromes are identified, i.e., Legionnaires' disease and Pontiac fever. Legionnaires' disease tends to occur in patients with underlying illnesses, so Legionella pneumonia should be included in the differential diagnosis of severe community-acquired pneumonia, especially in immunocompromised patients. Herein we report a case of community- acquired Legionnaires' disease in a patient with renal transplantation. A 63-year old man was admitted because of fever, chills, and dyspnea. Thirteen years ago, he had undergone kidney transplantation and he had received immu-nosuppressive agents, including deflazacort and cyclosporin A. On physical examination crackles were heard in the middle area of the right lung and the chest radiograph showed multifocal patchy consolidations on both lung fields. Serologic tests for Legionella pneumophila antibody, urinary antigen assay for L. pneumophila serogroup 1, and polymerase chain reaction for Legionella DNA fragments (5S rRNA, IPC, mip target sequence) were positive. The patient was treated with roxithromycin for twenty eight days and recovered without complication.

Keyword

Legionella; Pneumonia; Transplantation

MeSH Terms

Asymptomatic Infections
Chills
Cyclosporine
Diagnosis, Differential
DNA
Dyspnea
Fever
Humans
Immunocompromised Host
Kidney Transplantation
Legionella
Legionella pneumophila
Legionnaires' Disease*
Lung
Middle Aged
Physical Examination
Pneumonia
Polymerase Chain Reaction
Radiography, Thoracic
Respiratory Sounds
Roxithromycin
Serologic Tests
Transplantation*
Cyclosporine
DNA
Roxithromycin