Case Reports

ECMO Support in Pre-B-Cell ALL for Disseminated Legionnaire’s Disease

Louisiana State University Health Sciences Center, Children’s Hospital New Orleans, New Orleans, Louisiana; and The University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, Little Rock, Arkansas

Address correspondence to: Hannah K. Bauer, MD, Assistant Professor, Department of Pediatrics, Louisiana State University Health Sciences Center, Children’s Hospital New Orleans, 200 Henry Clay Avenue, New Orleans, LA 70118. E-mail: hbauer@lsuhsc.edu

Received: 12 March 2021
Accepted: 31 May 2021

Abstract

Legionella pneumophila is a common cause of community- and hospital-acquired pneumonia. Its increasing frequency and reemergence as a pathogen of interest in the intensive care unit is likely due to increased awareness, recognition, and diagnostic test availability (1). Extracorporeal Membrane Oxygenation (ECMO) is increasingly used in the pediatric intensive care unit (PICU) for refractory cardiopulmonary failure and acute respiratory distress syndrome (ARDS) in concert with conventional modalities or when these have failed to adequately support the patient. The breadth of applications for this technology are ever-expanding as our collective knowledge and experience grows. With a particularly high mortality rate among immunocompromised patients, Legionnaires’ disease should be considered early in the differential diagnosis and appropriate antimicrobials initiated (1). We present the case of an adolescent patient with pre-B-cell acute lymphoblastic leukemia (pre-B ALL) requiring ECMO support for septic shock and ARDS due to disseminated Legionella. To our knowledge, this is the first case describing an immunocompromised pediatric patient supported with ECMO for Legionnaires’ disease.