Community-acquired pneumonia due to Legionella pneumophila, the utility of PCR, and a review of the antibiotics used

Abstract

IntroductionThere are at least 40 types of Legionella bacteria, half of which are capable of producing disease in humans. The Legionella pneumophila bacterium, the root cause of Legionnaires’ disease, causes 90% of legionellosis cases.Case presentationWe describe the case of a 60-year-old woman with a history of diabetes mellitus and arterial hypertension who was admitted to our hospital with fever and symptoms of respiratory infection, diarrhea, and acute renal failure. We used real-time polymerase chain reaction (PCR) to detect L. pneumophila DNA in peripheral blood and serum samples and urine antigen from a patient with pneumonia. Legionella DNA was detected in all two sample species when first collected.ConclusionSince Legionella is a cause of 2% to 15% of all community-acquired pneumonias that require hospitalization, legionellosis should be taken into account in an atypical pulmonary infection and not be forgotten. Moreover, real-time PCR should be considered a useful diagnostic method.

Legionella pneumophila: The Journey from the Environment to the Blood

“…Some patients may also experience myalgia, diarrhea, and confusion. [ 102 , 103 , 104 ]. Usually, the presenting symptom is a mild, dry cough, that in 50% of the patients becomes productive.…”

“…In patients with suspected legionella pneumonia, a plain chest X-ray in the frontal and lateral projections is recommended. If the localization of the process is unknown, then it is advisable to take an X-ray in the right lateral projection [ 103 ]. The revealed changes on the chest X-ray and on the computed tomography in legionella lesions are nonspecific and characteristic of the most atypical pneumonias.…”

Whole-genome sequencing of the clinical isolate of Legionella pneumophila ALAW1 from the West Bank allows high-resolution typing and determination of pathogenicity mechanisms

“…Initial symptoms include fever, loss of appetite, headache, malaise, and lethargy. Some patients may also experience myalgia, diarrhea, and confusion [ 19 , 20 ]. On day 5, the patient had difficulty breathing with low oxygen and was transferred to the Intensive Care Unit (ICU) of a specialized hospital in East Jerusalem (hospital E) ( Figure S1 ) where bronchoalveolar lavage (BAL) and sputum) were collected to be analyzed by cultivation for bacterial pathogens.…”