title: Residential water supply as a likely cause of community-acquired Legionnaires' disease in an immunocompromised host.
abstract: A 69-year-old man with Sweet's syndrome and myelodysplastic syndrome presented with pneumonia and respiratory distress. He had been taking corticosteroids and methotrexate. The diagnosis of Legionnaires' disease was established by the isolation of Legionella pneumophila serogroup 6 from sputum and a fourfold seroconversion of Legionella antibodies to 1:512. Legionella pneumophila serogroup 6 was isolated from faucets in two homes owned by the patient. Strains of Legionella pneumophila serogroup 6 isolated from the patient's sputum and from one home were demonstrated to be genetically identical by pulsed-field gel electrophoresis but different from strains found in the other home and in a hospital outpatient clinic that he visited. This case illustrates an emerging public health issue concerning acquisition of community-acquired Legionnaires' disease from the homes of immunocompromised hosts. This is the first such case reported in Asia.
authors.affiliation: Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China. yschen@isca.vghks.gov.tw
authors.forename: Y-S
authors.initials: YS
authors.lastname: Chen
authors.forename: W-R
authors.initials: WR
authors.lastname: Lin
authors.forename: Y-C
authors.initials: YC
authors.lastname: Liu
authors.forename: C-L
authors.initials: CL
authors.lastname: Chang
authors.forename: V-L
authors.initials: VL
authors.lastname: Gan
authors.forename: W-K
authors.initials: WK
authors.lastname: Huang
authors.forename: T-S
authors.initials: TS
authors.lastname: Huang
authors.forename: S-R
authors.initials: SR
authors.lastname: Wann
authors.forename: H-H
authors.initials: HH
authors.lastname: Lin
authors.forename: S S-J
authors.initials: SS
authors.lastname: Lee
authors.forename: C-K
authors.initials: CK
authors.lastname: Huang
authors.forename: C
authors.initials: C
authors.lastname: Chin
authors.forename: Y-S E
authors.initials: YS
authors.lastname: Lin
authors.forename: M-Y
authors.initials: MY
authors.lastname: Yen
mesh_terms: D000368:Aged; D002681:China; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000209:etiology* / Q000276:immunology; D004269:DNA, Bacterial / Q000032:analysis; D016521:Electrophoresis, Gel, Pulsed-Field; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host; D016952:Legionella pneumophila / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D009190:Myelodysplastic Syndromes / Q000276:immunology; D013902:Radiography, Thoracic; D018570:Risk Assessment; D016463:Sweet Syndrome / Q000276:immunology; D014871:Water Microbiology; D014881:Water Supply
chemical_list: D004269:DNA, Bacterial