Volume 6, Number 61;  December 14, 2006 - Legionalla - Hemolysis

Patient: 40 yo HIV-negative- male w/ SOB, 25-lb wt loss, icterus, hepatomegaly, anemia, normal platelets.

Session Handout:

Readings:

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Unique Identifier [PMID]: 1879952

Authors: Hacker J. Ott M. Ludwig B. Rdest U.

Institution: Institut fur Genetik und Mikrobiologie, Universitat Wurzburg, Germany.

Title: Intracellular survival and expression of virulence determinants of Legionella pneumophila.

Source: Infection. 19 Suppl 4:S198-201, 1991.

Abstract: Legionella pneumophila, the causative agent of Legionnaires' disease is able to live and multiply within macrophages as well as within protozoan organisms. Legionella strains inhibit phagosome-lysosome fusion and phagosome acidification. By using two different cell culture systems, one derived from human macrophages and the other from human embryo lung fibroblastic cells, it is demonstrated that Legionella strains lose their virulence following cultivation in the laboratory. In order to study the mechanisms involved in intracellular survival of Legionella a genomic library of strain Legionella pneumophila Philadelphia I was established in Escherichia coli K-12. By cosmid cloning technique we were able to clone five putative virulence factors, two of which exhibit hemolytic activities and three of which represent membrane-associated proteins of 19, 26 and 60 kilodalton. One of the hemolytic proteins, termed legiolysin, represents a new toxin which specifically lyses human erythrocytes. The other hemolysin exhibits proteolytic properties in addition and is cytolytic for Vero and CHO cells. Further studies will be necessary to determine the exact role of the cloned proteins in the pathogenesis of Legionella.

Publication Type: Journal Article.

Fulltext Available in EBSCOHost Academic Search Premier

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Unique Identifier [PMID]: 6614685

Authors: Strikas R. Seifert MR. Lentino JR.

Title: Autoimmune hemolytic anemia and Legionella pneumophila pneumonia.

Source: Annals of Internal Medicine. 99(3):345, 1983 Sep.

Publication Type: Case Reports. Journal Article.

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Unique Identifier [PMID]: 7436651

Authors: King JW. May JS.

Title: Cold agglutinin disease in a patient with Legionnaires' disease.

Source: Archives of Internal Medicine. 140(11):1537-9, 1980 Nov.

Abstract: We present a case of Legionnaires' disease complicated by cold agglutinin disease. Therapy with erythromycin gluceptate was associated with resolution of both the pneumonia and the hemolysis. Complement-fixing antibody levels to Mycoplasma pneumoniae, influenza A, and adenoviruses were measured repeatedly throughout the clinical illness and were persistently nondiagnostic. The cold agglutinin present in the patient's serum was characterized as an IgM that demonstrated anti-I specificity. Thus, Legionella pneumophila should be considered a potential causative agent in patients with pneumonia and cold agglutinin disease.

Publication Type: Case Reports. Journal Article.

Resident Report / Department of Medicine & Grady Branch Library

Emory University School of Medicine

2006 Edition

Participating Faculty:  Carlos Del Rio MD  / Joyce Doyle MD / Lorenzo Difrancesco MD / Joel Mermis MD / Maunank Shah MD

Contact: Karl Woodworth