Severe pneumonia caused by Legionella pneumophila associated with Tropheryma whipplei: A case report
Abstract
Rationale: Legionella pneumophila (LP) and Tropheryma whipplei (TW) have been identified as pathogens that can coexist in sewage environments, which can both cause pneumophila and can impact various organs, leading to extrapulmonary manifestations. It is rare to find literature on pneumonia caused by atypical pathogens, such as the combination of LP and TW. There are no reports on specific drug treatments for such combined infections.
Patient concerns: A 55-year-old male with no underlying diseases developed community-acquired pneumonia. His condition worsened after empirical treatment with piperacillin/tazobactam. He subsequently experienced adverse drug reactions after using moxifloxacin.
Diagnoses: Pulmonary infection, pulmonary bullae.
Interventions: After admission, the patient was treated with piperacillin/tazobactam and moxifloxacin for anti-infection. He also underwent a bronchoscopy of the lungs, and the alveolar lavage fluid was tested using targeted next-generation sequencing. The results identified pathogens such as LP and TW. The anti-infection regimen was then adjusted to a combination of ceftriaxone and levofloxacin. Symptomatic treatments were also provided, including expectorant therapy, liver protection, and nutritional support.
Outcomes: The patient was discharged after showing signs of improvement and was subsequently monitored at an outpatient clinic.
Lessons: When empirical antibiotic therapy for pneumonia is ineffective, infections caused by atypical…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter?
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Development and validation of microbial bioassay for quantification of Levofloxacin in pharmaceutical preparations
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.