A case report of Legionella pneumonia complicated with Aspergillus infection after liver transplantation
Abstract
A case report of Legionella pneumonia complicated with Aspergillus infection after liver transplantation Dear Editor, Opportunistic pulmonary infection after liver transplantation may progress rapidly and is difficult to recognize because immunosuppression can blunt early manifestations.[1][2][3][4] We report a successfully treated case of Legionella pneumonia complicated by Aspergillus infection after liver transplantation.A 48-year-old man with hepatitis B cirrhosis and a 4.5-cm hepatocellular carcinoma in segment VIII underwent allogeneic orthotopic liver transplantation on October 8, 2025.Postoperatively, he received tacrolimus, sirolimus, and tapering corticosteroids.Acute rejection occurred on postoperative day 8 and improved after methylprednisolone pulse therapy.On October 28, the patient developed fever, peaking at 38.9 • C. Chest CT showed left lung consolidation (Fig. 1A).Immunosuppressants and corticosteroids were temporarily discontinued, and empirical meropenem was started.Next-generation sequencing confirmed Legionella pneumophila infection the following day, and moxifloxacin was administered; azithromycin Asian Journal of Surgery xxx (xxxx) xxx
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