Legionella maceachernii pneumonia: a case report and literature review

ABSTRACT

Background

Legionella maceachernii pneumonia is a severe respiratory infection with low incidence but high mortality. However, the optimal treatment for this disease remains unclear. We report a case of successful treatment of Legionella maceachernii pneumonia, which is the first report of such a case in China.

Case presentation

An 87-year-old man with concomitant chronic obstructive pulmonary disease, liver cirrhosis, and history of left nephrectomy was diagnosed with Legionella maceachernii pneumonia using Dano-seq pathogen metagenomic testing. After two weeks of treatment with cefoperazone/sulbactam combined with quinolone antibiotics, the patient showed improvement and was discharged. The patient continued to take oral quinolone antibiotics for one week after discharge and recovered during outpatient follow-up.

Conclusions

Dano-seq pathogen metagenomic testing can rapidly diagnose Legionella maceachernii pneumonia, and taking quinolone antibiotics is an effective treatment.

KEYWORDS:

• Legionella maceachernii
• pneumonia
• metagenomic testing
• quinolone antibiotics

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Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity that has financial interest or conflict with the subject matter or materials discussed in this manuscript, including employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, and royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

None stated.

Author contributions

YFG, MYF, and GFP contributed to the study design and manuscript preparation.

GFP and KXH conducted the data analysis. GFP, HHN, WZ, YY, YCX, JL, YJZ, and YTW collected the clinical specimens and information. All authors read and approved the final manuscript.

Ethics statement

The First People’s Hospital of Kunshan followed the medical research regulations of China, with the committee’s reference number [2023-03-019-K01]. Participatory consent was obtained from all patients.

Abbreviations

CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; PCT: procalcitonin; Hb: hemoglobin; GGT: γ-glutamyltransferase; ALB: serum albumin; TP: total protein; NT-proBNP: N-terminal pro-B-type natriuretic peptide; UAT: urinary antigen testing; MS: mass spectrometry analysis; PCR: polymerase chain reaction; LAMP: loop-mediated isothermal amplification; mNGS: metagenomic next-generation sequencing.

Additional information

Funding

This work was funded by the National Natural Science Foundation of China (No. 82370608), Natural Science Foundation of Anhui Province (No.2208085MH204), Natural Science Foundation of Education Department of Anhui Province (No. 2022AH040160), Recognition of the “Suzhou Municipal Health Young Backbone Talents” National Mentorship Training Program (No. Qngg2023046), and Kunshan Social Development Science and Technology Special (No. KS1719).