LUNG ABCESS COMPLICATING LEGIONELLA-MICDADEI PNEUMONIA IN AN ADULT LIVER-TRANSPLANT RECIPIENT

Legionella micdadei (Pittsburgh pneumonia agent) is the second most co mmon cause of Legionella pneumonia, and occurs predominantly in immuno compromised hosts. L micdadei is the cause of nosocomial pneumonia in renal transplant recipients, but has not been described in other adult solid organ transplant recipients. This report describes the first ca se of L micdadei pneumonia in an adult liver transplant recipient on i mmunosuppressive therapy. Importantly, this case highlights the diffic ulties in establishing the diagnosis, as the Legionella urinary antige n is negative, and special culture conditions are required. Furthermor e, this case illustrates several atypical clinical features of L micda dei pneumonia in a transplant recipient; including a community acquire d mode of transmission, occurrence several years after organ transplan tation, and lung abcess formation. The patient was successfully treate d with limited surgical resection and quinolone antimicrobial monother apy.