Legionnaires' Disease with Neurological Manifestations: Case Report
Abstract
INTRODUCTION. Legionnaires' disease may be manifested by neurological symptoms along with lung damage. Cerebellar ataxia and dysarthria are rare extrapulmonary manifestations of legionellosis. These symptoms significantly reduce the quality of life of patients. AIM. To analyze the literature data on neurological manifestations of legionellosis and to present a clinical case of Legionnaires' disease manifestation with neurological symptoms. MATERIAL AND METHODS. We performed an analysis of the available literature. Twenty-four Russian and international literature sources (PubMed databases) were evaluated, describing the characteristics and prevalence of neurological manifestations in Legionnaires' disease. We also described the main theories of the pathogenesis of these clinical manifestations. Our clinical case is presented. RESULTS AND DISCUSSION. As of today, few cases of Legionnaires' disease with cerebellar symptoms have been described. Dysarthria and ataxia are the most frequent manifestations of cerebellar dysfunction in legionellosis. Cases where neurologic symptoms persisted after the resolution of pneumonia have been described previously. There are also reports of manifestation of Legionnaires' disease with cerebellar ataxia. The pathophysiology of cerebellar involvement is unknown. There are hypotheses of toxin-mediated and immune-mediated mechanisms. Recent studies have shown that L. pneumophila can activate receptors responsible for enacting the inflammasome…
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