Legionella Pneumophila Pneumonia with Rapid Clinical Course in two Patients with Drug-Induced Liver Injury ：Case Report
Abstract
Drug-induced liver injury complicated by Legionella pneumophila pneumonia is rare and often associated with poor outcomes, including death. Early diagnosis and prompt treatment are crucial for these patients. Due to its low incidence, complex clinical presentation, atypical lung lesions, and challenges in pathogen culture, Legionella infection is frequently misdiagnosed or overlooked. The inability to identify the pathogen early often leads to inappropriate anti-infective therapy, resulting in a 15 % to 30 % mortality rate, primarily due to respiratory failure, shock, and multiorgan failure. The risk of infection is significantly higher in immunocompromised individuals, such as those with malignancies, chronic obstructive pulmonary disease, diabetes, liver failure, or those on glucocorticoid therapy. While hepatic and renal involvement is uncommon, we present two cases of drug-induced liver injury complicated by Legionella pneumonia.
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