title: Nosocomial legionnaires' disease in a bone marrow transplant unit.
abstract: We report the outcome of nosocomial legionnaires' disease in three patients who were isolated in the same sterile unit after allogeneic bone marrow transplantation. In all three cases the disease presented with dramatic pulmonary symptoms, and diagnosis was ascertained by direct immunofluorescence on bronchoalveolar fluids. None of the patients underwent seroconversion. This report draws attention to: (1) the fact that bacteriological filters do not ensure absolute security; (2) the need for frequent monitoring of the two factors governing legionella growth, water temperature and chlorination; and (3) the effectiveness of quinolones as a curative and prophylactic treatment of legionnaires' disease in transplanted patients avoiding pharmacological cyclosporin interaction.
authors.affiliation: Department of Haematology, Hôpital Jean-Bernard, CHRU, Poitiers, France.
authors.forename: E
authors.initials: E
authors.lastname: Benz-Lemoine
authors.forename: V
authors.initials: V
authors.lastname: Delwail
authors.forename: O
authors.initials: O
authors.lastname: Castel
authors.forename: F
authors.initials: F
authors.lastname: Guilhot
authors.forename: R
authors.initials: R
authors.lastname: Robert
authors.forename: G
authors.initials: G
authors.lastname: Grollier
authors.forename: F
authors.initials: F
authors.lastname: Roblot-Casenave
authors.forename: C
authors.initials: C
authors.lastname: Giraud
authors.forename: J
authors.initials: J
authors.lastname: Tanzer
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000473:pathology; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007875:Legionella / Q000302:isolation & purification; D007877:Legionnaires' Disease / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D008297:Male; D015363:Quinolones / Q000627:therapeutic use; D013696:Temperature
chemical_list: D015363:Quinolones