title: Documentation of Legionella pneumophila and Mycobacterium tuberculosis co-existence in a patient with acute respiratory distress syndrome.
abstract: BACKGROUND
  Bacterial lung infections are common causes of ARDS and, despite intensive research for decades, the mortality rate remains very high. Only two reports suggest the co-existence of Legionnaires' disease and pulmonary tuberculosis based mainly on clinical presentation and serologic results for Legionella and positive cultures for Mycobacterium tuberculosis (M. tuberculosis).
  
  
  METHODS
  A variety of specimens from a 61-year-old man was used for detection of Legionella pneumophila (L. pneumophila) and M. tuberculosis by PCR. Further identification of the pathogens was carried out by sequence analysis.
  
  
  RESULTS
  L. pneumophila region mip was detected in bronchial washings, bronchoalveolar lavage and urine specimens of the patient. M. tuberculosis regions IS6110 and mtp40 were detected in endo-bronchial secretions and bronchoalveolar lavage.
  
  
  CONCLUSIONS
  By using polymerase chain reaction (PCR) and DNA sequencing we documented L. pneumophila and M. tuberculosis co-existence, in multiple specimens of a patient presenting with acute respiratory distress syndrome (ARDS). Furthermore, the efficacy of the specific antibiotic treatment, based on the PCR results, suggest the co-existence of these two pathogens.
authors.affiliation: Molecular Biology Research Center, HYGEIA Antonis Papayiannis, Kifissias Ave. & 4 Erythrou Stavrou Str., 151 23 Maroussi, Athens, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Metaxa-Mariatou
authors.forename: A
authors.initials: A
authors.lastname: Ikonomou
authors.forename: A
authors.initials: A
authors.lastname: Tzortzi
authors.forename: M
authors.initials: M
authors.lastname: Mihalatos
authors.forename: N
authors.initials: N
authors.lastname: Vakalis
authors.forename: G
authors.initials: G
authors.lastname: Nasioulas
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000032:analysis; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000627:therapeutic use; D006801:Humans; D016952:Legionella pneumophila / Q000235:genetics / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D012293:Rifampin / Q000627:therapeutic use; D017422:Sequence Analysis, DNA; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D004269:DNA, Bacterial; D004917:Erythromycin; D012293:Rifampin