title: A case of Legionella pneumophila pneumonia followed by invasive aspergillosis.
abstract: We report a rare case of Legionella pneumophila pneumonia followed by invasive aspergillosis (IA). Legionellosis was ameliorated by the administration of ciprofloxacin, erythromycin, and corticosteroid as adjunctive therapy. Although intravenous administration of the corticosteroid was effective at reducing severe inflammation due to legionellosis, IA occurred at 12 days after admission. Combination therapy with micafungin and voriconazole was effective in this case; however, it remains necessary to exercise caution when making decisions regarding indications for corticosteroid use and observation in the treatment of severe pneumonia patients.
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Saijo
authors.forename: Koichi
authors.initials: K
authors.lastname: Izumikawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Takazono
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kosai
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kurihara
authors.forename: Shigeki
authors.initials: S
authors.lastname: Nakamura
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Imamura
authors.forename: Taiga
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Seki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kakeya
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yanagihara
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Kiyoyasu
authors.initials: K
authors.lastname: Fukushima
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use; D004917:Erythromycin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016952:Legionella pneumophila / Q000187:drug effects*; D007877:Legionnaires' Disease / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D008172:Lung Diseases, Fungal / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D002939:Ciprofloxacin; D004917:Erythromycin; D006854:Hydrocortisone