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      Cutaneous Legionella longbeachae Infection in Immunosuppressed Woman, United Kingdom

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          Abstract

          We report a rare case of cutaneous Legionella longbeachae infection in a patient receiving long-term corticosteroids for immune thrombocytopenia. Such infections cannot be identified by using Legionella urinary antigen testing but are commonly seen after exposure to commercial potting compost, particularly in immunocompromised patients.

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          Legionella longbeachae and Legionellosis

          Harriet Whiley, Richard Bentham (2011)
          Reported cases of legionellosis attributable to Legionella longbeachae infection have increased worldwide. In Australia and New Zealand, L. longbeachae has been a known cause of legionellosis since the late 1980s. All cases for which a source was confirmed were associated with potting mixes and composts. Unlike the situation with other Legionella spp., L. longbeachae–contaminated water systems in the built environment that cause disease have not been reported. Spatially and temporally linked outbreaks of legionellosis associated with this organism also have not been reported. Sporadic cases of disease seem to be limited to persons who have had direct contact with potting soil or compost. Long-distance travel of the organism resulting in infection has not been reported. These factors indicate emergence of an agent of legionellosis that differs in etiology from other species and possibly in route of disease transmission.
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            Does using potting mix make you sick? Results from a Legionella longbeachae case-control study in South Australia.

            K Eckert, R. C. Givney, Aaron Carman … (2006)
            A case-control study was performed in South Australia to determine if L. longbeachae infection was associated with recent handling of commercial potting mix and to examine possible modes of transmission. Twenty-five laboratory-confirmed cases and 75 matched controls were enrolled between April 1997 and March 1999. Information on underlying illness, smoking, gardening exposures and behaviours was obtained by telephone interviews. Recent use of potting mix was associated with illness (OR 4.74, 95% CI 1.65-13.55, P=0.004) in bivariate analysis only. Better predictors of illness in multivariate analysis included poor hand-washing practices after gardening, long-term smoking and being near dripping hanging flower pots. Awareness of a possible health risk with potting mix protected against illness. Results are consistent with inhalation and ingestion as possible modes of transmission. Exposure to aerosolized organisms and poor gardening hygiene may be important predisposing factors to L. longbeachae infection.
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              A cluster of Legionnaires' disease caused by Legionella longbeachae linked to potting compost in Scotland, 2008-2009.

              Blair Anderson, Kara J Stirling, S. Redmond … (2010)
              Three cases of Legionnaires disease caused by Legionella longbeachae Sg 1 associated with potting compost have been reported in Scotland between 2008 and 2009. The exact method of transmission is still not fully understood as Legionnaires disease is thought to be acquired by droplet inhalation. The linked cases associated with compost exposure call for an introduction of compost labelling, as is already in place in other countries where L. longbeachae outbreaks have been reported.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerging Infect. Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): August 2015
                Volume: 21
                Issue: 8
                Pages: 1426-1428
                Affiliations
                [1]South Devon Healthcare Foundation Trust, Torquay, UK (D. Grimstead, D. Tucker, D. Turner);
                [2]Great Ormond Street Hospital, NHS Foundation Trust, London, UK (K. Harris)
                Author notes
                Address for correspondence: Daniel Grimstead, Haematology Department, Torbay Hospital, South Devon Healthcare Trust, Lawes Bridge, Torquay, Devon, TQ2 7AA, UK; email: daniel.grimstead@ 123456nhs.net
                Article
                Publisher ID: 14-0828
                DOI: 10.3201/eid2108.140828
                PMC ID: 4517743
                PubMed ID: 26197048
                SO-VID: 929b7a30-d2f9-4b39-b16c-78af46c2e386
                History
                Categories
                Subject: Dispatch
                Subject: Dispatch
                Subject: Cutaneous Legionella longbeachae Infection in Woman, United Kingdom

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: legionellosis,legionella,chronic lymphocytic leukemia,immunosuppression,bacteria,united kingdom,legionella longbeachae,cutaneous
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: legionellosis, legionella, chronic lymphocytic leukemia, immunosuppression, bacteria, united kingdom, legionella longbeachae, cutaneous

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