Identification rate of Legionella species in non-purulent sputum culture is comparable to that in purulent sputum culture in Legionella pneumonia.

Many Legionella pneumonia patients do not produce sputum, and it is unknown whether purulent sputum is required for the identification of Legionella species. This study aimed to evaluate the identification rate of Legionella species based on sputum quality and the factors predictive of Legionella infection. This study included Legionella pneumonia patients at Kurashiki Central Hospital from November 2000 to December 2022. Sputum quality, based on gram staining, was classified as the following: Geckler 1/2, 3/6 and 4/5. Geckler 4/5 was defined as purulent sputum. The sputa of 104 of 124 Legionella pneumonia patients were cultured. Fifty-four patients (51.9%) were identified with Legionella species, most of which were Legionella pneumophila serogroup 1 (81.5%). The identification rates of Legionella species according to sputum quality were 57.1% (16/28) in Geckler 1/2 sputum, 50.0% (34/68) in Geckler 3/6 sputum, and 50.0% (4/8) in Geckler 4/5 sputum, which were not significantly different (P = 0.86). On multivariate analysis, pre-culture treatment with anti-Legionella antimicrobials (odds ratio [OR] 0.26, 95% confidence interval [CI] 0.06-0.91), Pneumonia Severity Index class ≥IV (OR 2.57 [95% CI 1.02-6.71]), and intensive care unit admission (OR 3.08, 95% CI 1.06-10.09) correlated with the ability to identify Legionella species, but sputum quality did not (OR 0.88, 95% CI 0.17-4.41). The identification rate of Legionella species in non-purulent sputum was similar to that in purulent sputum. For the diagnosis of Legionella pneumonia, sputum should be collected before administering anti-Legionella antibiotics and cultured regardless of sputum quality.

The Spectrum of Airway Involvement in Inflammatory Bowel Disease.

Inflammatory bowel disease is associated with a wide spectrum of central, large, and small airway abnormalities, including bronchiectasis. The bronchiectasis associated with inflammatory bowel disease has a distinct phenotype, with marked inflammation and at times severe sterile bronchorrhea that can be responsive to inhaled corticosteroids.

A case of hepatobronchial fistula in liver abscess / 대한내과학회지

We report an uncommon case of pyogenic hepatic abscess with hepatobronchial fistula. A 59 year-old male was admitted because of purulent sputum and cough. Ultrasonography and abdominal computed tomography showed an abscess on the superior segment of right hepatic lobe. Diagnostic and therapeutic percutaneous trans-hepatic abscessography disclosed hepatobronchial fistula. Liver abscess with hepatobronchial fistula was managed with percutaneous abscess drainage and antibiotics. The abscess was resolved and he is being on the follow-up with symptom free status.

A case of hepatobronchial fistula in liver abscess / 대한내과학회지

We report an uncommon case of pyogenic hepatic abscess with hepatobronchial fistula. A 59 year-old male was admitted because of purulent sputum and cough. Ultrasonography and abdominal computed tomography showed an abscess on the superior segment of right hepatic lobe. Diagnostic and therapeutic percutaneous trans-hepatic abscessography disclosed hepatobronchial fistula. Liver abscess with hepatobronchial fistula was managed with percutaneous abscess drainage and antibiotics. The abscess was resolved and he is being on the follow-up with symptom free status.