A Case of Legionnaire’s Disease
Abstract
, inspiratory rales and bilateral wide-spread expiratory rhonchi were detected. C-reactive protein was 324.3 mg/L, leukocytosis was 10980 10 3 /mm 3 , and neutrophil-dominated (90.2%). There was a respiratory failure according to the arterial blood gas analysis (PO2: 57.3 mmHg, HCO3: 25.7 mEq/L, PCO2: 33.6 mmHg, SO2: 91.3%). Moxifloxacin (400 mg 1×1) and oselta-mivir (75 mg 2×1) peroral empirically were initiated because of pneumonia, and additionally inhaler steroid and bronchodilator treatments (Salmeterol+flutikazon 50/500 mcg twice daily) for bronchitis. However, on the third day of follow-up, 40 mg methylprednisolone parenterally was added to the treatment because of bronchospasm and dyspnea continued despite bronchodilator therapy, and additionally parenteral ampicillin-sulbactam (4x1 gr.) was started to expand the spectrum of Gram-positive bacteria. Legionella was detected as the causative pathogen by viral and bacterial sampling of the airways with PCR. Low awareness about the disease may cause serious mortality and morbidity in patients presenting with a vague clinical picture in the early stages.
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