A case of severe pneumonia caused by Legionella longbeachae with positive results by a Legionella urinary antigen detection kit

Legionella longbeachae is a Legionella bacteria often detected in soil, and is known as a rare cause of Legionella infections in Japan. In addition, detection of this Legionella species is often overlooked due to negative results from Legionella urinary antigen tests, which could lead to errors in t...

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Published inTherapeutic advances in infectious disease Vol. 10; p. 20499361231179863
Main Authors Shinomiya, Shohei, Tanaka, Takuya, Shionoya, Ikuyo, Mura, Tatsuki, Nakase, Keisuke, Takahara, Yutaka, Oikawa, Taku, Mizuno, Shiro
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.01.2023
Sage Publications Ltd
Subjects
Antigens
C-reactive protein
Case Report
Case reports
Cell culture
Computed tomography
Dyspnea
Hyponatremia
Legionella
Leukocytes
Pneumonia
Respiration
Sputum
Legionella longbeachae
urinary antigen
intensive care
infectious disease
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Summary:Legionella longbeachae is a Legionella bacteria often detected in soil, and is known as a rare cause of Legionella infections in Japan. In addition, detection of this Legionella species is often overlooked due to negative results from Legionella urinary antigen tests, which could lead to errors in the therapeutic approach. An 80-year-old woman was admitted to our hospital because of fever and dyspnea. Her blood tests showed elevated white blood cells, increased C-reactive protein and transaminases, and hyponatremia. Chest computed tomography showed dense consolidation in the right lung. We diagnosed Legionella pneumonia because the Legionella urinary antigen test was positive on the day after her admission. The patient was intubated and mechanically ventilated on the third day of hospitalization, because of respiratory failure. However, her condition did not improve and she died on the 10th day after admission. After her death, L. longbeachae was detected from sputum culture from her tracheal tube, and was diagnosed as the causative organism of her pneumonia. L. longbeachae infection reportedly rarely produces positive urinary antigen test results. Our experience suggests that the urinary antigen test using Ribotest Legionella might be able to detect Legionella spp. other than L. pneumophila.
ISSN:2049-9361
2049-937X
DOI:10.1177/20499361231179863