LEGIONELLOSIS IN A BONE-MARROW TRANSPLANT CENTER

We reviewed 10 cases of culture proven legionellosis that occurred at a marrow transplant center (Fred Hutchinson Cancer Research Center, Se attle, WA, USA) over a 6-year period ending in 1993, Infections were c aused by four species of Legionella with no apparent clustering of cas es, Detection of Legionella using direct fluorescent antibody assays p roved unreliable due to the high proportion of rare Legionella species isolated, The clinical presentation, course and outcome of patients v aried and did not correlate with underlying disease, type of transplan t, transplant day or engraftment status, However, five of the seven pa tients infected with non-pneumophila species recovered from their pneu monia compared to none of the three patients infected with L, pneumoph ila. Persistent or relapsed infection after 3 weeks of appropriate the rapy was documented in one case suggesting that prolonged antibiotic t reatment is indicated in these patients.