A case of Legionella pneumophila pneumonia followed by invasive aspergillosis.
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.
Saijo
Tomomi
T
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan.
Izumikawa
Koichi
K
Takazono
Takahiro
T
Kosai
Kosuke
K
Kurihara
Shintaro
S
Nakamura
Shigeki
S
Imamura
Yoshifumi
Y
Miyazaki
Taiga
T
Seki
Masafumi
M
Kakeya
Hiroshi
H
Yamamoto
Yoshihiro
Y
Yanagihara
Katsunori
K
Miyazaki
Yoshitsugu
Y
Fukushima
Kiyoyasu
K
Kohno
Shigeru
S
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
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D002939:Ciprofloxacin; D004917:Erythromycin; D006854:Hydrocortisone