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Journal of Endotoxin Research
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Tremendous high plasma lipopolysaccharide concentrations in a patient with Legionella pneumophila pneumonia

K. Laczika

Department of Internal Medicine I, Intensive Care Unit 13 I2

S. Knapp

Department of Internal Medicine I, Intensive Care Unit 13 I2

G.J. Locker

Department of Internal Medicine I, Intensive Care Unit 13 I2

F. Thalhammer

Division of infectious Diseases, University of Vienna, Austria

B. Stoiser

Division of infectious Diseases, University of Vienna, Austria

M. Frass

Department of Internal Medicine I, Intensive Care Unit 13 I2

H. Burgmann

Division of infectious Diseases, University of Vienna, Austria

We describe a patient suffering from nosocomial Legionella pneumophila pneumonia with extremely high lipopolysaccharide (LPS) concentrations (peak concentration = 725 EU/ml). This unexpectedly high LPS load led to an exaggerated response of the cytokine network. Although immediate treatment with macrolides was instituted, the patient developed an adult respiratory distress syndrome. Despite application of nitric oxide and porcine natural surfactant factor, the patient died 5 days after admission to the ICU. Because of this dramatic case, we emphasize physicians to be aware of L. pneumophila and to include this organism into the diagnosis and antibiotic therapy in patients with nosocomial pneumonia.

Journal of Endotoxin Research, Vol. 4, No. 4, 301-304 (1997)
DOI: 10.1177/096805199700400408
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