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Cutaneous legionellosis: case report and review of the medical literature.
[legionellosis]
Discrete
nodules
developed
on
the
leg
of
a
27
-
year
-old
immunosuppressed
woman
after
an
allogeneic
stem
cell
transplant
.
Biopsy
and
culture
grew
Legionella
pneumophila
serogroup
8
.
On
day
7
of
azithromycin
treatment
,
respiratory
distress
and
abnormal
liver
transaminases
developed
,
and
the
patient
died
on
day
14
.
Review
of
the
medical
literature
identified
19
reports
of
Legionella
species-associated
skin
or
soft
tissue
infections
(
total
of
20
patients
,
13
with
confirmed
infection
)
.
Manifestations
of
the
13
confirmed
cases
included
erythematous
macular
rash
(
n
=
7
)
,
erythema
after
thoracentesis
(
n
=
1
)
,
abscess
formation
(
n
=
4
)
,
respiratory
symptoms
(
n
=
6
)
,
and
abnormal
chest
radiographs
(
n
=
8
)
.
Six
required
surgical
exploration
and
débridement
,
and
7
were
immunocompromised
.
Rash
and
respiratory
infection
improved
with
antibiotics
in
10
,
but
3
died
.
Immunosuppression
may
predispose
transplant
recipients
to
Legionella
infections
.
Diagnostic
biopsies
may
facilitate
appropriate
treatment
.
