Hot spring bath and Legionella pneumonia: an association confirmed by genomic identification.
A 59-year-old man developed pneumonia 9 days after bathing in a hot spring spa. Bilateral shadows on his chest radiograph rapidly progressed after admission. He was successfully treated with erythromycin and rifampicin. Legionella pneumophila serogroup 6 was recovered from an intratrachial specimen and a significant elevation was observed in a paired indirect fluorescent antibody to Legionella. Persistent slight fever and chest rentogenographic shadows resolved after administering low-dose prednisolone to treat organizing pneumonia shown by transbronchial lung biopsy. The same serotype of Legionella was recovered from the water of the hot spring spa where the man had bathed. When the extracted DNA of these two strains showed identical restriction fragments by pulsed-field gel electrophoresis, we had direct evidence that hot spring spas can be a source of Legionella pneumonia.
Ito
Isao
I
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University.
Naito
Junko
J
Kadowaki
Seizo
S
Mishima
Michiaki
M
Ishida
Tadashi
T
Hongo
Toshiharu
T
Ma
Ling
L
Ishii
Yoshikazu
Y
Matsumoto
Tetsuya
T
Yamaguchi
Keizo
K
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D001494:Baths / Q000009:adverse effects*; D004269:DNA, Bacterial / Q000032:analysis*; D004197:Disease Reservoirs; D016521:Electrophoresis, Gel, Pulsed-Field; D004917:Erythromycin / Q000627:therapeutic use; D005798:Genes, Bacterial; D006801:Humans; D016952:Legionella pneumophila / Q000235:genetics / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome; D014871:Water Microbiology
D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D004269:DNA, Bacterial; D004917:Erythromycin; D012293:Rifampin