Septic shock due to co-infection with Legionella pneumophila and Saprochaete clavata

João Paulo Caldas; André Silva-Pinto; Ana Sofia Faustino; Paulo Figueiredo; António Sarmento; Lurdes Santos

doi:10.1016/j.idcr.2021.e01369

Septic shock due to co-infection with Legionella pneumophila and Saprochaete clavata

IDCases. 2021 Dec 20:27:e01369. doi: 10.1016/j.idcr.2021.e01369. eCollection 2022.

Authors

João Paulo Caldas¹, André Silva-Pinto¹, Ana Sofia Faustino¹, Paulo Figueiredo¹, António Sarmento¹, Lurdes Santos¹

Affiliation

¹ Infectious Diseases Department of Centro Hospitalar Universitário de São João, Oporto, Portugal.

Abstract

Septic shock is the most dreaded presentation of an infection, carrying a reserved prognosis. Appropriate antimicrobial therapy is therefore the mainstay of treatment, alongside organ support as needed. Legionnaires' disease is mainly due to Legionella pneumophila serogroup 1 but it can be caused by other serogroups and species not detected by the urinary antigen test. Anti-tumour necrosis factor α therapy may increase the risk of invasive fungal infection, which carry a poor prognosis. We present a challenging case of a septic shock due to Legionella pneumophila and Saprochaete clavata infections, with a review of the two infections presented.

Keywords: Anti-TNF-α therapy; Extracorporeal membrane oxygenation; Invasive ventilation; Legionnaires’ disease; Plasmapheresis; Renal replacement therapy; Saprochaete clavata.

Publication types

Case Reports