Graft involvement by Legionella in a liver transplant recipient

Y. Tokunaga, W. Concepcion, W. E. Berquist, K. L. Cox, L. D. Wiviott, R. Garcia-Kennedy, H. Itasaka, P. Nakazato and C. O. Esquivel
California Pacific Medical Center Transplant Services, San Francisco.

Legionella pneumophila, serogroup 1, was identified by direct immunofluorescence in the lung and liver graft from a 2 1/2-month-old infant who underwent orthotopic liver transplantation because of fulminant hepatic failure secondary to neonatal hepatitis. The patient died of respiratory failure owing to this infection 22 days after transplantation despite treatment with erythromycin lactobionate. To our knowledge, this represents the first reported case of hepatic infection with Legionella in liver transplant recipients.