Legionella pneumophila and Pneumocystis jirovecii coinfection in an infant treated with adrenocorticotropic hormone for infantile spasm: case report and literature review

J Child Neurol. 2014 Feb;29(2):240-2. doi: 10.1177/0883073813511148. Epub 2013 Dec 5.

Abstract

We describe an 8-month-old infant with infantile spasms treated with adrenocorticotropic hormone (ACTH) who presented with fatal Legionella pneumophila and Pneumocystis jirovecii infection. Emphasis is placed on the ensuing immunosuppression and infectious sequelae of ACTH therapy. Given that ACTH therapy may increase the risk of fatal infection, patients undergoing such treatment should be closely monitored, with particular attention paid to the functioning of the immune system.

Keywords: Legionella pneumophila; Pneumocystis jirovecii; adrenocorticotropic hormone; immunosuppression; infantile spasms.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenocorticotropic Hormone / administration & dosage
  • Adrenocorticotropic Hormone / adverse effects*
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / adverse effects*
  • Coinfection / drug therapy
  • Coinfection / etiology*
  • Fatal Outcome
  • Female
  • Humans
  • Immune Tolerance
  • Infant
  • Legionella pneumophila
  • Legionnaires' Disease / drug therapy
  • Legionnaires' Disease / etiology*
  • Pneumocystis carinii*
  • Pneumonia, Pneumocystis / drug therapy
  • Pneumonia, Pneumocystis / etiology*
  • Pneumonia, Pneumocystis / therapy
  • Spasms, Infantile / drug therapy*

Substances

  • Anticonvulsants
  • Adrenocorticotropic Hormone