Abstract
Introduction:Unlike other Legionella species, Legionella longbeachae has been associated with soil and potting composts instead of water systems, and it has caused pneumonia in gardeners.Case presentation:We report, to our knowledge, the first case of prolonged localized L. longbeachae infection in an accidental wound on the back of a hand caused by a broken flowerpot.Conclusion:Identification of L. longbeachae requires awareness and expertise, since commercial tests are most often specific for L. pneumophila.
Highlights
Unlike other Legionella species, Legionella longbeachae has been associated with soil and potting composts instead of water systems, and it has caused pneumonia in gardeners.Case presentation: We report, to our knowledge, the first case of prolonged localized L. longbeachae infection in an accidental wound on the back of a hand caused by a broken flowerpot
While Legionella pneumophila sg 1 remains the predominant pathogenic strain, other Legionella species are emerging as significant pathogens
L. longbeachae differs from other Legionella species by special risk factors and habitat; it has been connected to potting soil and potting composts instead of man-made water systems or other aquatic systems (Steele et al, 1990; Currie et al, 2014)
Summary
In addition to respiratory symptoms, Legionnaires’ disease is associated with gastrointestinal and neurological symptoms, and can involve the liver, kidneys and skin (Edelstein, 2011). To our knowledge, the first case of a localized infection by L. longbeachae in an accidental wound on the back of the hand from a broken flowerpot. The following week, the patient fell over, requiring suturing of a wound on her right elbow Three days later she returned with increased swelling and redness of her right hand, but no fever. Antibiotic therapy was restarted with a combination of i.v. clindamycin and piperacillin/tazobactam Both the elbow and hand wound were surgically debrided. Because there was no clinical response after 5 days of this wide-spectrum antibiotic therapy, and because the only positive microbiological finding was a single positive Gram stain, the decision was made to forward the sample for bacterial PCR and DNA sequencing (Helsinki University Central Hospital laboratory HUSLAB, Finland). Antibiotic therapy was switched to a four-week course of oral levofloxacin, and according to a follow-up phone call to the patient, resulted in the rapid resolution of all signs of infection
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