Miocardite fulminante a Legionella pneumophila – a propósito dum caso clínico

Pneumonia is the most commonly described manifestation of Legionella pneumophila infection (legionellosis), and extrapulmonary manifestations are uncommon. There are a few descriptions of acute myocarditis associated with legionellosis. We present a case of acute myocarditis in a patient admitted for legionellosis with multisystemic involvement (lung, heart, and kidney). Left ventricular (LV) dysfunction was documented by cardiac magnetic resonance (CMR) and two-dimensional speckle-tracking echocardiography; layer-specific strain analyses were performed, which allowed to differentiate subendocardial or subepicardial contractile impairment. Layer-specific strain analyses by echocardiography demonstrated impairment of subepicardial deformation in the inferolateral wall, which mirrored CMR findings, showing late gadolinium enhancement in the subepicardium of the same LV segments. After initiation of appropriate antibiotic therapy with levofloxacin, LV systolic function rapidly improved as assessed by both CMR and strain analyses, with concomitant normalization of both clinical and biochemical abnormalities. The basic mechanisms of myocardial involvement during legionellosis are unclear; we discussed our findings according to the limited available evidence.

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Acute Myocarditis Associated with Legionella Infection

Spighi

Coiro

Morroni

et al. 2021

Journal of Cardiovascular Echography

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Regional Myocarditis due to Legionella Masquerading as Dual-Chamber Cardiac Arrhythmia

Ghazal,

Ahmed,

Bawa

et al. 2023

AIM Clinical Cases

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Disseminated Legionella Associated With Myocarditis in an Otherwise Immunocompetent Host: A Case Report and Review of the Literature

Jarrah,

Mansour,

Alnasarat

et al. 2023

Cureus

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Legionnaires’ disease caused by the bacteria Legionella pneumophila, is considered a type of atypical pneumonia. The disease usually presents with dyspnea, cough, fever, muscle aches, headache, nausea, and vomiting. A milder form of the disease (Pontiac fever) with flu-like illness also exists. In addition to lung infection, extrapulmonary manifestations might occur including sepsis, rhabdomyolysis, neurological impairment, kidney, and liver damage. Myocarditis can be seen as a rare complication in Legionnaires’ disease. Here, we are presenting a case of Legionnaires’ disease associated with myocarditis in a patient with no predisposing risk factors for severe illness.

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Miocardite fulminante a Legionella pneumophila – a propósito dum caso clínico

Cited by 3 publications

References 8 publications

Acute Myocarditis Associated with Legionella Infection

Acute Myocarditis Associated with Legionella Infection

Regional Myocarditis due to Legionella Masquerading as Dual-Chamber Cardiac Arrhythmia

Disseminated Legionella Associated With Myocarditis in an Otherwise Immunocompetent Host: A Case Report and Review of the Literature

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