Septic shock due to co-infection with Legionella pneumophila and Saprochaete clavata

Abstract

Septic shock is the most dreaded presentation of an infection, carrying a reserved prognosis. Appropriate antimicrobial therapy is therefore the mainstay of treatment, alongside organ support as needed. Legionnaires’ disease is mainly due to Legionella pneumophila serogroup 1 but it can be caused by other serogroups and species not detected by the urinary antigen test. Anti-tumour necrosis factor α therapy may increase the risk of invasive fungal infection, which carry a poor prognosis. We present a challenging case of a septic shock due to Legionella pneumophila and Saprochaete clavata infections, with a review of the two infections presented.

Keywords

• Legionnaires’ disease
• Saprochaete clavata
• Anti-TNF-α therapy
• Extracorporeal membrane oxygenation
• Renal replacement therapy
• Plasmapheresis