Relapsing Legionella pneumophila cellulitis: a case report and review of the literature

J Infect Chemother. 2010 Dec;16(6):439-42. doi: 10.1007/s10156-010-0072-6. Epub 2010 Jun 5.

Abstract

Legionella spp. rarely cause soft tissue infections, with only a few cases reported and usually in the setting of immunocompromise. We report a case of L. pneumophila cellulitis, without pneumonia, in a 65-year-old immunocompromised woman. The patient had a history of interstitial lung disease and idiopathic thrombocytopenic purpura, for which she was receiving high-dose corticosteroids, and had recently experienced an episode of L. pneumophila cellulitis of the lower extremity, which responded to an extended course of levofloxacin. She was initially transferred to this institution for definitive workup of presumed B cell lymphoma and, during her hospital course, suffered a relapse of L. pneumophila-associated cellulitis that responded promptly to azithromycin. More unusual organisms such as Legionella spp. should be considered in the etiology of cellulitis, particularly in the setting of immunocompromise, in cases that are refractory to conventional antibiotics routinely administered for skin and soft tissue infections.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / therapeutic use
  • Cellulitis / drug therapy
  • Cellulitis / microbiology*
  • Cellulitis / prevention & control*
  • Fatal Outcome
  • Female
  • Humans
  • Immunocompromised Host
  • Legionella pneumophila / classification
  • Legionella pneumophila / drug effects
  • Legionella pneumophila / genetics
  • Legionella pneumophila / isolation & purification*
  • Legionnaires' Disease / drug therapy
  • Legionnaires' Disease / microbiology*
  • Legionnaires' Disease / prevention & control*
  • Levofloxacin
  • Ofloxacin / therapeutic use
  • Recurrence

Substances

  • Anti-Bacterial Agents
  • Levofloxacin
  • Azithromycin
  • Ofloxacin