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Although H63T was isolated from a patient and no environmental source was identified in the case history, it is undoubtedly true that the novel species exists naturally in freshwaters, as is the case for most other legionellae. However, it is difficult to predict if and when an environmental isolation of the species would occur, based on what has been seen for other Legionella species. Indeed, most Legionella species were monotypic in their initial description . In the case of Legionella tucsonensis, since the publication of its clinical isolation in the 1980s, additional strains have yet to be described, despite years of environmental sampling and clinical surveillance .Of the 55 previously characterized Legionella species, 26 have been isolated from clinical cases and, in 25 of those instances, they were believed to be the likely causative agent of disease . Eleven additional species have been linked to disease through serology . We therefore conclude that the novel species represents the fifty- sixth Legionella species, and the thirty-seventh to be linked to disease. Although the lung is the typical primary site for Legionella infections, extrapulmonary manifestations do occur, and legionellae have been found in various niches within the body including the spleen, lymph node, blood, kidney, liver, skin, bone, sinus and heart . In the heart, Legionella infection can take the form of myocarditis, pericarditis or endocarditis. There have been 18 documented cases of Legionella endocarditis, including the recent isolation of H63T . Four Legionella species, L.pneumophila, L.micdadei, L.dumoffii and L.longbeachae, have been implicated in prosthetic valve endocarditis; however, only L.pneumophila has been isolated from a native heart . Therefore, the novel species represents the first non-pneumophila species to be isolated from native valve endocarditis.
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