Abstract
We report a rare case of Legionella pneumophila pneumonia followed by invasive aspergillosis (IA). Legionellosis was ameliorated by the administration of ciprofloxacin, erythromycin, and corticosteroid as adjunctive therapy. Although intravenous administration of the corticosteroid was effective at reducing severe inflammation due to legionellosis, IA occurred at 12 days after admission. Combination therapy with micafungin and voriconazole was effective in this case; however, it remains necessary to exercise caution when making decisions regarding indications for corticosteroid use and observation in the treatment of severe pneumonia patients.
MeSH terms
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Anti-Bacterial Agents / administration & dosage
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Anti-Bacterial Agents / therapeutic use
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Anti-Inflammatory Agents / administration & dosage
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Anti-Inflammatory Agents / adverse effects*
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Anti-Inflammatory Agents / therapeutic use
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Antifungal Agents / administration & dosage
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Antifungal Agents / therapeutic use
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Aspergillosis / complications*
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Aspergillosis / drug therapy
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Aspergillosis / microbiology
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Aspergillus fumigatus / isolation & purification
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Ciprofloxacin / administration & dosage
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Ciprofloxacin / therapeutic use
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Erythromycin / administration & dosage
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Erythromycin / therapeutic use
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Humans
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Hydrocortisone / administration & dosage
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Hydrocortisone / adverse effects*
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Hydrocortisone / therapeutic use
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Legionella pneumophila / drug effects*
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Legionnaires' Disease / complications*
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Legionnaires' Disease / drug therapy
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Legionnaires' Disease / microbiology
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Lung Diseases, Fungal / complications
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Lung Diseases, Fungal / drug therapy
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Lung Diseases, Fungal / microbiology
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Male
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Middle Aged
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Treatment Outcome
Substances
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Anti-Bacterial Agents
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Anti-Inflammatory Agents
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Antifungal Agents
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Ciprofloxacin
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Erythromycin
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Hydrocortisone