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Relapse of Legionnaires' Disease in a Renal Transplant Recipient

Relapse of Legionnaires' Disease in a Renal Transplant Recipient Abstract We describe a 44-year-old man who recently received a cadaveric renal transplant and had a relapse of Legionnaires' disease after an appropriate course of therapy. The relapse occurred within two weeks after completion of a three-week course of therapy with erythromycin stearate. A transbronchial biopsy specimen was positive for Legionella pneumophila by direct immunofluorescence, although the Dieterle silver impregnation stain was negative. The patient responded to a repeated course of erythromycin for an additional 21 days, and no further sequelae or relapses have been noted. The importance of early rapid diagnostic modalities in the immunocompromised patient is emphasized, and the need to consider the possibility of relapse after effective therapy is warranted. (Arch Intern Med 140:833-834, 1980) References 1. Saravolatz LD, Burch KH, Fisher E, et al: The compromised host and Legionnaires' disease. Ann Intern Med 90:533-537, 1979.Crossref 2. Kirby BD, Snyder KM, Meyer RD, et al: Legionnaires' disease: Clinical features of 24 cases. Ann Intern Med 89:297-309, 1978.Crossref 3. Renner ED, Helms CM, Hierholzer WJ, et al: Legionnaires' disease in pneumonia patients in Iowa. Ann Intern Med 90:603-606, 1979.Crossref 4. McDade JE, Shepard CC, Fraser DW, et al: Legionnaires' disease: Isolation of bacterium and demonstration of its role in other respiratory disease. N Engl J Med 297:1197-1203, 1977.Crossref 5. Tsai TF, Fraser DW: Diagnosis of Legionnaires' disease. Ann Intern Med 89:413-414, 1978.Crossref 6. Beaty HN, Miller AA, Broome CV, et al: Legionnaires' disease in Vermont. JAMA 240:127-131, 1978.Crossref 7. Broome CV, Cherry WB, Winn WC, et al: Rapid diagnosis of Legionnaires' disease by direct immunofluorescent staining. Ann Intern Med 90:1-4, 1979.Crossref 8. Fraser DW, Bopp C, Wachsmuth IK, et al: Antibiotic treatment of guinea pigs infected with agent of LD. Lancet 1:175-177, 1978.Crossref 9. Saravolatz LD, Tilchen E: Legionnaires' disease: Description of a sporadic case. Henry Ford Hosp Med 25:293-298, 1977. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Relapse of Legionnaires' Disease in a Renal Transplant Recipient

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References (11)

Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1980.00330180107030
Publisher site
See Article on Publisher Site

Abstract

Abstract We describe a 44-year-old man who recently received a cadaveric renal transplant and had a relapse of Legionnaires' disease after an appropriate course of therapy. The relapse occurred within two weeks after completion of a three-week course of therapy with erythromycin stearate. A transbronchial biopsy specimen was positive for Legionella pneumophila by direct immunofluorescence, although the Dieterle silver impregnation stain was negative. The patient responded to a repeated course of erythromycin for an additional 21 days, and no further sequelae or relapses have been noted. The importance of early rapid diagnostic modalities in the immunocompromised patient is emphasized, and the need to consider the possibility of relapse after effective therapy is warranted. (Arch Intern Med 140:833-834, 1980) References 1. Saravolatz LD, Burch KH, Fisher E, et al: The compromised host and Legionnaires' disease. Ann Intern Med 90:533-537, 1979.Crossref 2. Kirby BD, Snyder KM, Meyer RD, et al: Legionnaires' disease: Clinical features of 24 cases. Ann Intern Med 89:297-309, 1978.Crossref 3. Renner ED, Helms CM, Hierholzer WJ, et al: Legionnaires' disease in pneumonia patients in Iowa. Ann Intern Med 90:603-606, 1979.Crossref 4. McDade JE, Shepard CC, Fraser DW, et al: Legionnaires' disease: Isolation of bacterium and demonstration of its role in other respiratory disease. N Engl J Med 297:1197-1203, 1977.Crossref 5. Tsai TF, Fraser DW: Diagnosis of Legionnaires' disease. Ann Intern Med 89:413-414, 1978.Crossref 6. Beaty HN, Miller AA, Broome CV, et al: Legionnaires' disease in Vermont. JAMA 240:127-131, 1978.Crossref 7. Broome CV, Cherry WB, Winn WC, et al: Rapid diagnosis of Legionnaires' disease by direct immunofluorescent staining. Ann Intern Med 90:1-4, 1979.Crossref 8. Fraser DW, Bopp C, Wachsmuth IK, et al: Antibiotic treatment of guinea pigs infected with agent of LD. Lancet 1:175-177, 1978.Crossref 9. Saravolatz LD, Tilchen E: Legionnaires' disease: Description of a sporadic case. Henry Ford Hosp Med 25:293-298, 1977.

Journal

Archives of Internal Medicine – American Medical Association

Published: Jun 1, 1980

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