Fatal Fulminant Legionnaires' Disease in a Patient on Maintenance Hemodialysis

Akira Kawashima; Daisuke Katagiri; Isao Kondo; Emi Sakamoto; Minami Suzuki; Yohei Arai; Fumie Sato; Manami Tada; Fumihiko Hinoshita

doi:10.2169/internalmedicine.4530-20

This article has now been updated. Please use the final version.

Fatal Fulminant Legionnaires' Disease in a Patient on Maintenance Hemodialysis

Akira Kawashima, Daisuke Katagiri, Isao Kondo, Emi Sakamoto, Minami Suzuki, Yohei Arai, Fumie Sato, Manami Tada, Fumihiko Hinoshita

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Keywords: atypical pneumonia, hemodialysis patients, immunocompromised hosts, Legionella pneumophila

JOURNAL OPEN ACCESS Advance online publication

Article ID: 4530-20

DOI https://doi.org/10.2169/internalmedicine.4530-20

The final version of this article is now available: Vol. 59 (2020), No. 15 pp. 1913-1918

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Abstract

We herein report a case of fulminant Legionnaires' disease with autopsy findings in a patient on maintenance hemodialysis (HD). Chronic kidney disease is a strong risk factor for Legionnaires' disease, although there have been only a few reports in HD patients. Because most patients on HD are anuric, the use of rapid assay kits to detect antigens in urine samples for the diagnosis of Legionnaires' disease is not always feasible. We suggest the use of clinical predictive tools or the loop-mediated isothermal amplification (LAMP) method, which can be applied for anuric patients, such as those on HD, with pneumonia.

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