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J Med Microbiol ; 57(Pt 2): 240-243, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18201993

RESUMEN

We describe the case of a 66-year-old man with a culture-proven Legionella pneumonia after kidney transplantation. The patient developed the infection 15 days after discharge from a university hospital. Legionella pneumonia caused by Legionella pneumophila serogroup 5/10 was established by positive direct fluorescence assay, positive urinary-antigen detection and isolation of the causative agent. The infection was successfully treated by giving appropriate antibiotics, but the further course was complicated by invasive aspergillosis, cytomegalovirus pneumonia, failure of the transplanted kidney and development of septic anaemia. Four months after the diagnosis of Legionella pneumonia the patient died of multi-organ failure. The microbiological and epidemiological investigation revealed that strains from the water supply of the patient's private home were indistinguishable from the patient's isolate by amplified fragment length polymorphism analysis and sequence-based typing (SBT). Unrelated strains of serogroups 4, 5, 8 and 10 from the Dresden strain collection were of different SBT types. Thus, SBT is a very useful tool for epidemiological investigation of infections by L. pneumophila serogroups other than serogroup 1.


Asunto(s)
Infecciones Comunitarias Adquiridas/microbiología , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios/microbiología , Anciano , Análisis del Polimorfismo de Longitud de Fragmentos Amplificados , Antibacterianos/uso terapéutico , Aspergilosis/complicaciones , Infecciones Comunitarias Adquiridas/complicaciones , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones por Citomegalovirus/complicaciones , Resultado Fatal , Técnica del Anticuerpo Fluorescente Directa , Humanos , Trasplante de Riñón , Legionella pneumophila/clasificación , Enfermedad de los Legionarios/complicaciones , Enfermedad de los Legionarios/tratamiento farmacológico , Enfermedad de los Legionarios/epidemiología , Masculino , Epidemiología Molecular , Neumonía Viral , Insuficiencia Renal/complicaciones , Sepsis/complicaciones , Serotipificación , Orina/microbiología , Microbiología del Agua
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