Bittner K, Bittinger A, Lange H
Dtsch Med Wochenschr. 1987 Feb 6;112(6):214-8. doi: 10.1055/s-2008-1068032.
In a kidney-transplant patient, there was superinfection of the lungs by Klebsiella pneumoniae and Legionella pneumophilia with multiple necroses in the course of a primary cytomegalovirus infection. In a later phase of the disease, there was an opportunistic colonization of the necrotic cavities and the adjacent lung tissue by Aspergillus fumigatus and Candida albicans. The cytomegalovirus infection led to a pronounced cellular immunosuppression in the patient. This favored superinfections by bacteria and fungi. A poor nutritional state and a chronic lung disease are to be considered as predisposing risk factors.