Isolation of Legionella maceachernii from an immunocompromised patient with severe underlying lung disease.

Abstract

OBJECTIVE: To present the first case in Australia in which Legionella maceachernii has been documented as a cause of infection. CLINICAL FEATURES: A 71-year-old retired carpenter with underlying autoimmune disease and pulmonary fibrosis was admitted to hospital with increasing shortness of breath and fever, and pneumonia was diagnosed. INTERVENTION AND OUTCOME: He was treated with ampicillin then gentamicin and flucloxacillin and later imipenem but his condition deteriorated with progression of the pneumonia and abscess formation and he died 25 days after admission. Subsequently, L. maceachernii was isolated from three sputum samples collected before the patient died. CONCLUSION: There is a need for clinical awareness of the value of sputum culture in the diagnosis of infection due to Legionella spp. other than L. pneumophila.