Rapidly Expanding Pulmonary Nodule Caused by Pittsburgh Pneumonia Agent
- A. Robin Ellis, MD;
- Douglas L. Mayers, MD;
- William J. Martone, MD;
- Barbara L. Mitchell, MS;
- Nuzhet O. Atuk, MD;
- Richard L. Guerrant, MD
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
PITTSBURGH pneumonia agent (PPA), also known as TATLOCK and HEBA, and tentatively ascribed to the genus Legionella (L micdadei), has recently been identified as a cause of pneumonia in patients receiving high-dose steroid therapy for rejection of renal transplants.1-4 We report a case of a rapidly expanding pulmonary nodule caused by PPA in an immunosuppressed renal transplant patient.
Report of a Case A 59-year-old man had a cadaveric renal transplantation because of renal failure caused by familial polycystic kidney disease. After transplantation, he was given prednisone, 2 mg/kg/day, and azathioprine, 3 mg/kg/day. During the next six weeks of hospitalization, he had four episodes of acute graft rejection, each treated with methylprednisolone sodium succinate pulse therapy, 30 to 90 mg/kg/day for three days. He was discharged from the hospital with instructions to take prednisone, 70 mg/day, and azathioprine, 50 mg/day, but was readmitted one week later for a rising serum
Footnotes
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Reprint requests to Department of Internal Medicine, Box 485, School of Medicine, University of Virginia, Charlottesville, VA 22908 (Dr Guerrant).
