PMID- 1647138
OWN - NLM
STAT- MEDLINE
DCOM- 19910725
LR  - 20181113
IS  - 0002-9440 (Print)
IS  - 1525-2191 (Electronic)
IS  - 0002-9440 (Linking)
VI  - 138
IP  - 6
DP  - 1991 Jun
TI  - Pneumonitis associated with coinfection by human herpesvirus 6 and Legionella in 
      an immunocompetent adult.
PG  - 1405-11
AB  - The authors report a case of pneumonitis in a young healthy man caused by 
      coinfection with human herpesvirus 6 (HHV-6) and Legionella pneumophila. The 
      patient's course was complicated by severe respiratory, renal, hepatic, and 
      central nervous system dysfunctions, which were believed to be primarily the 
      results of his Legionella infection. Aggressive antibiotic treatment produced no 
      response, and Legionella remained isolatable from lung tissue throughout several 
      weeks of antimicrobial therapy. Human herpesvirus 6 was isolated from a sample of 
      peripheral blood during the acute stage of the patient's illness, and numerous 
      HHV-6--infected macrophages and lymphocytes were detected by immunohistochemical 
      staining of biopsy-derived lung tissue. Paradoxically treatment of the patient 
      with high-dose corticosteroids resulted in dramatic improvement of his condition, 
      including clearance of the Legionella infection. The demonstration that 
      corticosteroids efficiently inhibit HHV-6 replication in vitro suggests that the 
      virus may have contributed to the patient's pneumonitis by enhancing tissue 
      inflammation, by compromising the function of pulmonary macrophages, and, 
      perhaps, by destroying the patient's CD4+ T lymphocytes. Human herpesvirus 6 may 
      be able to function as a synergistic cofactor in lung infections by Legionella 
      and other pathogens.
FAU - Russler, S K
AU  - Russler SK
AD  - Department of Medicine, Medical College of Wisconsin, Milwaukee 53226.
FAU - Tapper, M A
AU  - Tapper MA
FAU - Knox, K K
AU  - Knox KK
FAU - Liepins, A
AU  - Liepins A
FAU - Carrigan, D R
AU  - Carrigan DR
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Pathol
JT  - The American journal of pathology
JID - 0370502
RN  - 0 (Adrenal Cortex Hormones)
SB  - IM
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Adult
MH  - Herpesviridae Infections/*complications
MH  - *Herpesvirus 6, Human/drug effects/isolation & purification
MH  - Humans
MH  - *Immune Tolerance
MH  - Legionellosis/*complications
MH  - Male
MH  - Multiple Organ Failure/etiology
MH  - Pneumonia/complications/drug therapy/*metabolism
MH  - Virus Replication/drug effects
PMC - PMC1886405
EDAT- 1991/06/01 00:00
MHDA- 1991/06/01 00:01
PMCR- 1991/12/01
CRDT- 1991/06/01 00:00
PHST- 1991/06/01 00:00 [pubmed]
PHST- 1991/06/01 00:01 [medline]
PHST- 1991/06/01 00:00 [entrez]
PHST- 1991/12/01 00:00 [pmc-release]
PST - ppublish
SO  - Am J Pathol. 1991 Jun;138(6):1405-11.