Journal Article

Legionnaires Disease with Bacteremic Coinfection

Michael J. Tan, James S. Tan and Thomas M. File

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 5, pages 533-539
Published in print September 2002 | ISSN: 1058-4838
Published online September 2002 | e-ISSN: 1537-6591 | DOI:
Legionnaires Disease with Bacteremic Coinfection

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We describe 6 patients who had bacteremic community-acquired pneumonia and unsuspected Legionella pneumophila coinfection. We reviewed case records of patients who were diagnosed as having a recent Legionella infection on the basis of either the presence of L. pneumophila serogroup 1 antigen in urine or a 4-fold increase in L. pneumophila antibody level and with a blood culture that yielded a bacterium other than L. pneumophila. Three patients were diagnosed with legionellosis on the basis of the presence of antigen in urine, and 3 were diagnosed on the basis of a 4-fold increase in antibody titer. Of these 6 patients, 4 were infected with Streptococcus pneumoniae, 1 with Streptococcus pyogenes, and 1 with Enterobacter cloacae. L. pneumophila infection in these patients may have predisposed them to concomitant bacteremia. Initial empiric antimicrobial therapy for patients who live in areas of endemicity and who are smokers should be treated with antimicrobial agents that have activity against pneumococcus and Legionella species.

Journal Article.  4430 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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