Legionella micdadei lung abscess in a patient with HIV- associated nephropathy

A patient with end-stage renal disease due to human immunodeficiency-associ ated nephropathy developed fever, cough and chest pain over a week's durati on. He was diagnosed with lung abscess and started on antibiotic coverage. He underwent bronchoscopy because of progression of his illness and persist ent fever and bronchoalveolar lavage culture isolated Legionella micdadei. in spite of appropriate antibiotic therapy, the patient remained febrile fo r 10 days, necessitating chest tube drainage. After a 6-week course of anti biotics and drainage, the patient made an uneventful recovery. Infections d ue to I. micdadei may be hard to diagnose because of difficulties in isolat ing this bacteria.