Diagnostic methods and therapeutics strategies of Legionella infection in postbone marrow transplantation.

Abstract

Organ transplantation represents a critical therapeutic intervention for patients with end-stage organ failure or hematological malignancies, often serving as a last-resort treatment. Among these, bone marrow transplantation (BMT) is vital but complex, as it induces profound and long-lasting immunosuppression. Patients undergoing BMT are highly vulnerable to opportunistic infections due to concurrent chemotherapy, radiation, and immunosuppressive therapies. Legionella infections emerge as a significant threat, accounting for considerable morbidity and mortality in hospitalized immunocompromised individuals. These infections often progress rapidly to severe pneumonia, with high mortality rates compared to those infecting immunocompetent people. Early and accurate diagnosis remains challenging due to nonspecific clinical presentations and limitations of conventional microbiological methods. Consequently, timely detection using advanced diagnostic tools and therapeutic intervention is necessary. This comprehensive review critically observes the epidemiology, risk factors, diagnostic methods, clinical manifestations, and treatments of Legionella in BMT recipients. It emphasizes the need for institutional prevention protocols to alleviate the exposure risks to reduce the burden of Legionella-related complications in high-risk BMT recipients.