Failure to produce detectable antibodies to Legionella pneumophila by an immunocompetent adult.
A case of legionella pneumonia diagnosed by co-culture with amoebae and urinary antigen detection is described. Diagnostic antibody tests remained negative despite prolonged follow-up. Investigation showed no evidence of an under-lying immunodeficiency. The value of culture-based diagnosis and consequences of missed diagnoses are discussed.
McWhinney
P H
PH
Department of Infectious Diseases, Seacroft Hospital, Leeds, UK.
Ragunathan
P L
PL
Rowbottham
T J
TJ
D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D000911:Antibodies, Monoclonal; D000942:Antigens, Bacterial / Q000652:urine; D002439:Cefotaxime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D018920:Coculture Techniques; D004797:Enzyme-Linked Immunosorbent Assay; D004917:Erythromycin / Q000627:therapeutic use; D019085:Fluorescent Antibody Technique, Direct; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007121:Immunocompetence; D016952:Legionella pneumophila / Q000187:drug effects / Q000276:immunology*; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D013183:Sputum / Q000382:microbiology; D014195:Travel; D014421:Turkey; D006113:United Kingdom
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D000911:Antibodies, Monoclonal; D000942:Antigens, Bacterial; D002511:Cephalosporins; D010406:Penicillins; D004917:Erythromycin; D000658:Amoxicillin; D017291:Clarithromycin; D002439:Cefotaxime