Concurrent infection with Legionella pneumophila and Pneumocystis carinii in a patient with adult T cell leukemia.
A 48-year-old woman was admitted to our hospital with high fever, chills, cough, and exertional dyspnea. On admission, the chest roentgenogram and computed tomography scan showed bilateral alveolar infiltration in the middle and lower lung fields. Microscopic examination of the bronchial lavage fluid showed flower cells typical for adult T-cell leukemia (ATL) and cysts of Pneumocystis carinii, and Legionella pneumophila serogroup 1 grew on buffered charcoal yeast extract (BCYE)-alpha agar. The patient was successfully treated with antibiotics including trimethoprim/sulfamethoxazole, erythromycin, and sparfloxacin. Remission of ATL was achieved after three courses of antileukemic chemotherapy. Mixed infection of opportunistic pathogens should be considered in patients with ATL.
Arakaki
N
N
First Department of Internal Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa.
Higa
F
F
Tateyama
M
M
Yamazato
Y
Y
Yara
S
S
Ishimine
T
T
Toyama
M
M
Miyara
T
T
Koide
M
M
Saito
A
A
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000382:microbiology; D001999:Bronchoscopy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016952:Legionella pneumophila / Q000276:immunology / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015458:Leukemia, T-Cell / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011010:Pneumocystis / Q000276:immunology / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial