The Diagnosis of Legionella pneumophila Serogroup 5 Bacteremic Pneumonia during Severe Neutropenia Using Loop-mediated Isothermal Amplification

Intern Med. 2018 Apr 1;57(7):1045-1048. doi: 10.2169/internalmedicine.9810-17. Epub 2017 Dec 21.

Abstract

A 60-year-old man developed pneumonia after undergoing autologous peripheral blood stem cell transplantation for diffuse large-B cell lymphoma. A urinary antigen test and sputum culture were both negative for Legionella pneumophila; however, a sputum sample that was examined by loop-mediated isothermal amplification (LAMP) was positive for Legionella spp. On admission, the results of blood culturing using a BACTEC system were negative for 7 days. However, L. pneumophila serogroup 5 was detected in a blood subculture using WYOα medium. The patient was successfully treated with a fluoroquinolone-based regimen. LAMP is useful for the diagnosis of Legionella spp.

Keywords: Legionella pneumonia; Legionella pneumophila serogroup 5; hematological malignancy; loop-mediated isothermal amplification; malignant lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Aminoacridines
  • Bacteremia / genetics*
  • Fluoroquinolones / therapeutic use*
  • Humans
  • Legionella pneumophila / classification*
  • Legionnaires' Disease / diagnosis*
  • Legionnaires' Disease / drug therapy*
  • Lymphoma / therapy
  • Male
  • Middle Aged
  • Neutropenia / diagnosis
  • Neutropenia / microbiology
  • Nucleic Acid Amplification Techniques*
  • Peripheral Blood Stem Cell Transplantation / adverse effects
  • Pneumonia / diagnosis*
  • Pneumonia / diagnostic imaging
  • Pneumonia / microbiology
  • Serogroup
  • Sputum / microbiology
  • Treatment Outcome

Substances

  • Aminoacridines
  • Fluoroquinolones
  • fluoroquinacrine