L. pneumophila serogroup 13 and drowning?

L. pneumophila serogroup 13 and drowning: A female aged 27 year old was admitted to intensive care unit with respiratory failure due to aspiration pneumonia after drowning in River Clyde in Glasgow, Scotland, UK. Culture of tracheal aspirate yielded growth of Legionella pneumophila serogroup 13. The patient seroconverted to Legionella pneumophila serogroup 13 before she died of respiratory failure.

 

My questions are:

  1. How significant is Legionella pneumophila serogroup 13 in a patient with aspiration pneumonia?
  2. Has this particular serogroup been associated with Legionnaires’ disease in patient who drowned in urban river water?
  3. Has been any documented case fatality reports of Legionella pneumophila serogroup 13 in the literature? If Yes, Please provide the references.

  1. Serogroup 13 is extremely unusual and we have never documented a culture-confirmed case. However, Mona Schousboe New Zealand and Chris Heath Australia have documented 1 case each of culture-confirmed serogroup 13 in community-acquired legionellosis. (Yu VL, et al J Infect Dis 2002; 186:127-128). In this international surveillance study of culture-confirmed community-acquired LD, 2/508 patients were infected by serogroup 13.
  2. No. There have been 2 cases of drowning associated with Legionnaires’ disease. A serogroup 10 in the Lancet 1988:2:460 and serogroup 3 Kansenshogaku Zasshi Dec 1995;69:1356-1364. This is further evidence of the importance of aspiration.
  3. Not to our knowledge. You have a reportable case! I will put you in touch with Christopher Health and Mona Schousboe and you should combine your experience into an important case report. I suggest you consider Emerging Infectious Disease as the journal for submission.
  4. Epilogue: Faris B, Faris C, Schousboe M, Heath CM. Legionellosis from L. pneumophila serogroup 13. Emerg Infect Dis 2005; 11:1407-1411.