scholarly journals Immune-Mediated Encephalopathy in the Setting of Legionnaires Disease: A Case Report and Review of the Literature

2021 ◽  
Vol 4 (1) ◽  
pp. 54-59
Author(s):  
Abdel-Rahim M ◽  
Chow J ◽  
Singhal M
Keyword(s):  
Legionella Pneumophila ◽  
Signs And Symptoms ◽  
Advanced Heart Failure ◽  
Negative Bacterium ◽  
Review Of The Literature ◽  
Urinary Antigen ◽  
Laboratory Findings ◽  
Gram Negative ◽  
Immune Mediated ◽  
Legionnaires Disease

Background: Legionnaires disease is the systemic manifestation of an infection by the gram-negative bacterium Legionella pneumophila. It most commonly presents with pneumonia, but can also cause extrapulmonary manifestations like cardiac, renal, gastrointestinal as well as neurologic symptoms like encephalopathy. It tends to occur in people who are elderly, immunocompromised and those with impaired respiratory (smokers) or cardiac (advanced heart failure) functions. The Legionella Urinary antigen is commonly used to diagnose Legionella infection. Almost half of the patients diagnosed with Legionnaires disease exhibit neurologic signs and symptoms. These neurologic abnormalities are usually not evident on neuroimaging, laboratory findings, and neuropathology.

scholarly journals Comparison of the Novel Immunocatch Legionella Test with Sofia Legionella FIA Assay and with BinaxNOW Legionella Card Assay for Detection ofLegionella pneumophila(Serogroup 1) Antigen in Urine Samples

2019 ◽  
Vol 57 (8) ◽  
Author(s):  
F. Congestrì ◽  
M. Morotti ◽  
R. Vicari ◽  
M. F. Pedna ◽  
M. Sparacino ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Signs And Symptoms ◽  
Laboratory Diagnosis ◽  
Antigen Detection ◽  
Urine Samples ◽  
Urinary Antigen ◽  
Content Type ◽  
High Clinical Suspicion ◽  
Legionnaires Disease ◽  
Urinary Antigen Detection

ABSTRACTLegionnaires’ disease (LD) refers to a serious form of acute pneumonia caused byLegionellaspecies. LD can be difficult to diagnose because the signs and symptoms are nonspecific, and therefore a rapid laboratory diagnosis is of paramount importance. In this study, a recently introduced immunochromatographic test (Immunocatch Legionella; Eiken Chemical Co., Ltd.) forLegionella pneumophila(serogroup 1) urinary antigen detection was compared with the Sofia Legionella fluorescent immunoassay (FIA) (Quidel) (routinely used in our laboratory) and with the widely used BinaxNOW Legionella assay (Alere). A total of 248 urine samples (60 frozen and 188 fresh) were evaluated. All of the samples were collected from patients with high clinical suspicion of Legionnaires’ disease. The three assays were performed simultaneously according to the manufacturers’ instructions. A total of 180 concordant negative and 66 concordant positive results were obtained. Only 2 discrepant results were registered. The sensitivity and specificity of Immunocatch compared with Sofia were, respectively, 98.5% and 99.4%. Cohen's kappa coefficient and overall percent agreement between Immunocatch and Sofia were also calculated and resulted in, respectively, 0.97 and 99.2%. These performances suggest that the Immunocatch test is a useful tool forLegionella pneumophila(serogroup 1) urinary antigen detection.

scholarly journals Legionnaires' Disease - Results of a Multicenter Canadian Study

2003 ◽  
Vol 14 (3) ◽  
pp. 154-158 ◽  
Author(s):  
Thomas J Marrie ◽  
Emidio de Carolis ◽  
Victor L Yu ◽  
Janet Stout ◽  
Keyword(s):  
Legionella Pneumophila ◽  
Tertiary Care ◽  
Community Acquired Pneumonia ◽  
The Other ◽  
Urinary Antigen ◽  
Serum Samples ◽  
Eastern Canada ◽  
Legionnaires Disease ◽  
Canadian Provinces ◽  
A Prospective Study

BACKGROUND: There has never been a cross-Canada surveillance project to determine the rate ofLegionellaspecies as a cause of community-acquired pneumonia requiring hospitalization and to determine whether there are any regional differences in the rates of Legionnaires' disease in Canada. Anecdotally, Legionnaires' disease is thought to be uncommon in Western Canada.METHODS: From January, 1996 through to October 31, 1997, a prospective study of the etiology of community acquired pneumonia requiring admission to 15 tertiary care hospitals in eight Canadian provinces was conducted. A urine sample from each patient was tested forLegionella pneumophilaserogroup 1 antigen using a commercially available ELISA assay. A culture of sputum or other respiratory specimens for Legionellaceae was carried out at the discretion of the attending physician. Two hundred thirty-four patients had acute and 6-week convalescent serum samples tested for antibodies toL pneumophilaserogroups 1 through 6 using an ELISA method.RESULTS: 28 of the 850 patients (3.2%) had Legionnaires' disease; 18 of 823 (2.1%) were positive forL pneumophilaserogroup 1 by urinary antigen testing. The rate of Legionnaires' disease, based on urinary antigen, at the Halifax site was higher than that at the other sites (seven of 163 patients versus 11 of 660 [P=0.04]). Of the 28 cases of Legionnaires' disease identified using all methods, 11 of 277 patients (3.9%) were enrolled from Western provinces versus 17 of 573 patients (2.9%) from Eastern provinces (P=nonsignificant).CONCLUSIONS: Legionnaires' disease is just as common in Western as in Eastern Canada.L pneumophilaserogroup 1 may be more common in Halifax than at the other sites studied.

scholarly journals Detection of Cardiobacterium valvarum in a patient with aortic valve infective endocarditis by broad-range PCR

2010 ◽  
Vol 59 (2) ◽  
pp. 231-234 ◽  
Author(s):  
Martina Vaněrková ◽  
Barbora Žaloudíková ◽  
Eva Němcová ◽  
Jana Juránková ◽  
Jiří Pol ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Gene Sequencing ◽  
16S Rrna Gene Sequencing ◽  
Rrna Gene ◽  
Negative Bacterium ◽  
Review Of The Literature ◽  
Gram Negative ◽  
Prosthetic Aortic Valve ◽  
Rrna Gene Sequencing

Cardiobacterium valvarum, a fastidious Gram-negative bacterium, was detected in the aortic valve of a previously healthy 63-year-old man by broad-range PCR and 16S rRNA gene sequencing. In contrast to the patients in five previously published cases, our patient had neither a congenital bicuspid nor a prosthetic aortic valve. Here, we present a case of C. valvarum native tricuspid aortic valve infective endocarditis and a review of the literature.

scholarly journals Molecular mechanism of elongation factor 1A inhibition by a Legionella pneumophila glycosyltransferase

2010 ◽  
Vol 426 (3) ◽  
pp. 281-292 ◽  
Author(s):  
Ramon Hurtado-Guerrero ◽  
Tal Zusman ◽  
Shalini Pathak ◽  
Adel F. M. Ibrahim ◽  
Sharon Shepherd ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Binding Sites ◽  
Substrate Recognition ◽  
Elongation Factor ◽  
Negative Bacterium ◽  
Glucose Binding ◽  
Legionnaires Disease ◽  
Organelle Trafficking ◽  
Intracellular Multiplication ◽  
Positively Charged

Legionnaires' disease is caused by a lethal colonization of alveolar macrophages with the Gram-negative bacterium Legionella pneumophila. LpGT (L. pneumophila glucosyltransferase; also known as Lgt1) has recently been identified as a virulence factor, shutting down protein synthesis in the human cell by specific glucosylation of EF1A (elongation factor 1A), using an unknown mode of substrate recognition and a retaining mechanism for glycosyl transfer. We have determined the crystal structure of LpGT in complex with substrates, revealing a GT-A fold with two unusual protruding domains. Through structure-guided mutagenesis of LpGT, several residues essential for binding of the UDP-glucose-donor and EF1A-acceptor substrates were identified, which also affected L. pneumophila virulence as demonstrated by microinjection studies. Together, these results suggested that a positively charged EF1A loop binds to a negatively charged conserved groove on the LpGT structure, and that two asparagine residues are essential for catalysis. Furthermore, we showed that two further L. pneumophila glycosyltransferases possessed the conserved UDP-glucose-binding sites and EF1A-binding grooves, and are, like LpGT, translocated into the macrophage through the Icm/Dot (intracellular multiplication/defect in organelle trafficking) system.

scholarly journals Unusual clinical picture in an overweight patient with Legionella pneumophila: A case report

2017 ◽  
Vol 4 (3) ◽  
pp. 31
Author(s):  
Leonidas Grigorakos ◽  
Daria Lazarescu ◽  
Anthi Georgiadou ◽  
Maria Bikou ◽  
Magda Gkouni ◽  
...  
Keyword(s):  
Case Report ◽  
Legionella Pneumophila ◽  
Clinical Picture ◽  
Clinical Condition ◽  
Antigen Test ◽  
Overweight Patient ◽  
Urinary Antigen ◽  
Urinary Antigen Test ◽  
Legionnaires Disease ◽  
Continue Therapy

This case report describes a case of a patient with Legionnaires’ disease (LD) manifested three days upon his return from a medical conference, which took place in a hotel close to the seaside. Our patient presented to the hospital febrile, weak, confused and with mild difficulty in breathing. After being subjected to several tests, he was diagnosed with LD. Even though his initial urinary antigen test (UAT) was negative, subsequent immunofluorescent assays (IFA) were positive for Legionella pneumophila (LP). The patient was immediately initiated specific antibiotics therapy and supportive measures. After 11 days he was released from the hospital with considerable melioration of his clinical condition and with specific instructions to continue therapy at home.

scholarly journals Legionella pneumophila Type II Protein Secretion Promotes Virulence in the A/J Mouse Model of Legionnaires' Disease Pneumonia

2004 ◽  
Vol 72 (1) ◽  
pp. 310-321 ◽  
Author(s):  
Ombeline Rossier ◽  
Shawn R. Starkenburg ◽  
Nicholas P. Cianciotto
Keyword(s):  
Protein Secretion ◽  
Legionella Pneumophila ◽  
Complete Analysis ◽  
Type Ii Secretion ◽  
Type Ii ◽  
Kinetic Assay ◽  
Genome Database ◽  
Gram Negative ◽  
Legionnaires Disease

ABSTRACT Legionella pneumophila, the gram-negative agent of Legionnaires' disease, possesses type IV pili and a type II protein secretion (Lsp) system, both of which are dependent upon the PilD prepilin peptidase. By analyzing multiple pilD mutants and various types of Lsp mutants as well as performing trans-complementation of these mutants, we have confirmed that PilD and type II secretion genes are required for L. pneumophila infection of both amoebae and human macrophages. Based upon a complete analysis of lspDE, lspF, and lspG mutants, we found that the type II system controls the secretion of protease, RNase, lipase, phospholipase A, phospholipase C, lysophospholipase A, and tartrate-sensitive and tartrate-resistant acid phosphatase activities and influences the appearance of colonies. Examination of the developing L. pneumophila genome database indicated that the organism has two other loci (lspC and lspLM) that are predicted to promote secretion and thus a set of genes that is comparable to the type II secretion genes in other gram-negative bacteria. In contrast to lsp mutants, L. pneumophila pilus mutants lacking either the PilQ secretin, the PspA pseudopilin, or pilin were not defective for colonial growth, secreted activities, or intracellular replication. L. pneumophila dot/icm mutants were also not impaired for type II-dependent exoenzymes. Upon intratracheal inoculation into A/J mice, lspDE, lspF, and pilD mutants, but not pilus mutants, exhibited a reduced ability to grow in the lung, as measured by competition assays. The lspF mutant was also defective in an in vivo kinetic assay. Examination of infected mouse sera revealed that type II secreted proteins are expressed in vivo. Thus, the L. pneumophila Lsp system is a virulence factor and the only type II secretion system linked to intracellular infection.

scholarly journals A Rare Case of Pneumonia Caused byShewanella putrefaciens

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Rajshree Patel ◽  
Albin Abraham ◽  
Johnson Thomas ◽  
Wanqing Zhi ◽  
Shadab Ahmed ◽  
...  
Keyword(s):  
Sea Water ◽  
Shewanella Putrefaciens ◽  
Gram Negative Bacteria ◽  
Soft Tissue Infections ◽  
Review Of The Literature ◽  
Endotracheal Aspirate ◽  
Laboratory Findings ◽  
Gram Negative ◽  
Empirical Antibiotic Treatment ◽  
Clinical Syndromes

Shewanella putrefaciensis a gram-negative, nonfermentative, oxidase positive, motile bacillus that produces hydrogen sulphide. It is found widely in the nature especially in marine environments. In some very rare casesShewanella putrefacienscan be a human pathogen. It can produce a wide variety of clinical syndromes including bacteremia as well as skin and soft tissue infections. However, pneumonia due toS. putrefaciensis rare; there are a total of 4 reported cases in the literature. We present a case of 63-year-old male who was presented to emergency room status after cardiac arrest, fell into sea water face down. On the second day of hospitalization, he was diagnosed to have pneumonia based on the clinical, radiological, and laboratory findings. Empirical antibiotic treatment with vancomycin and piperacillin/tazobactam combination was initiated. Gram-stained smear of endotracheal aspirate yielded gram-negative bacteria, and the isolate grown from endotracheal aspirate culture was identified asS. putrefaciensby Biomerieux API 20 NE technique. On review of the literature and according to culture and sensitivity results, therapy in our patient was changed to cefepime. Patient’s pneumonia improved with treatment with cefepime. We believe that our patient developed pneumonia evidently caused byS. putrefaciens, after near drowning in sea water. The pneumonia resolved after treatment with cefepime.

scholarly journals Legionella hijacks the host Golgi-to-ER retrograde pathway for the association of Legionella-Containing vacuole with the ER

2021 ◽  
Vol 17 (3) ◽  
pp. e1009437
Author(s):  
Mio Kawabata ◽  
Honoka Matsuo ◽  
Takumi Koito ◽  
Misaki Murata ◽  
Tomoko Kubori ◽  
...  
Keyword(s):  
Endoplasmic Reticulum ◽  
Legionella Pneumophila ◽  
Early Stage ◽  
Physiological Role ◽  
Snare Proteins ◽  
Negative Bacterium ◽  
Gram Negative ◽  
Bacterial Proteins ◽  
Host Membrane

Legionella pneumophila (L. pneumophila) is a gram-negative bacterium that replicates in a compartment that resembles the host endoplasmic reticulum (ER). To create its replicative niche, L. pneumophila manipulates host membrane traffic and fusion machineries. Bacterial proteins called Legionella effectors are translocated into the host cytosol and play a crucial role in these processes. In an early stage of infection, Legionella subverts ER-derived vesicles (ERDVs) by manipulating GTPase Rab1 to facilitate remodeling of the Legionella-containing vacuole (LCV). Subsequently, the LCV associates with the ER in a mechanism that remains elusive. In this study, we show that L. pneumophila recruits GTPases Rab33B and Rab6, which regulate vesicle trafficking from the Golgi to the ER, to the LCV to promote the association of LCV with the ER. We found that recruitment of Rab6 to the LCV depends on Rab33B. Legionella effector SidE family proteins, which phosphoribosyl-ubiquitinate Rab33B, were found to be necessary for the recruitment of Rab33B to the LCV. Immunoprecipitation experiments revealed that L. pneumophila facilitates the interaction of Rab6 with ER-resident SNAREs comprising syntaxin 18, p31, and BNIP1, but not tethering factors including NAG, RINT-1, and ZW10, which are normally required for syntaxin 18-mediated fusion of Golgi-derived vesicles with the ER. Our results identified a Rab33B-Rab6 cascade on the LCV and the interaction of Rab6 with ER-resident SNARE proteins for the association of LCV with the ER and disclosed the unidentified physiological role of SidE family proteins.

scholarly journals Evaluation of the Binax and Biotest Urinary Antigen Kits for Detection of Legionnaires' Disease Due to Multiple Serogroups and Species of Legionella

2000 ◽  
Vol 38 (7) ◽  
pp. 2763-2765 ◽  
Author(s):  
Robert F. Benson ◽  
Patrick W. Tang ◽  
Barry S. Fields
Keyword(s):  
Immunosorbent Assay ◽  
Broad Spectrum ◽  
Legionella Pneumophila ◽  
Urine Samples ◽  
Enzyme Linked Immunosorbent Assay ◽  
Urinary Antigen ◽  
Legionnaires Disease

The Binax and the Biotest urinary antigen kits for the detection of Legionnaires' disease caused by organisms other than Legionella pneumophila were compared by testing 45 urine samples from non-Legionella pneumophila serogroup 1 patients previously positive in a broad-spectrum enzyme-linked immunosorbent assay (ELISA). Eighteen were positive with the Binax kit, and 13 were positive with the Biotest. Although neither kit is as sensitive as ELISA, these results extend the number of serogroups and species ofLegionella that can be diagnosed with the Binax or Biotest kit.

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