C57-08 A Rare Case of Legionella Longbeachae Pneumonia Linked to Indoor Plant Exposure
Abstract
Legionella longbeachae is an uncommon cause of community-acquired pneumonia in the United States, often associated with exposure to soil or potting mix rather than contaminated water sources typical of Legionella pneumophila. Due to its rarity and nonspecific presentation, accounting for only 0.3-3% of Legionella infections diagnosis is often delayed, potentially leading to severe respiratory failure.
A 47-year-old man with a history of tobacco use disorder and kratom use presented with worsening shortness of breath, fever, and productive cough. Symptoms began shortly after working in his attic furnace. Initial chest Xray at an outside hospital showed right-sided infiltrates, and laboratory evaluation revealed leukocytosis, elevated procalcitonin and lactic acidosis. Despite empiric broad-spectrum antibiotics initially with a ceftriaxone and azithromycin, later escalated to cefepime and vancomycin his respiratory status deteriorated, prompting transfer to our facility. On arrival, he was hypoxemic (SpO2 80s on OptiFlow), tachycardic, and in respiratory distress. Repeat chest Xray showed diffuse progressive bilateral infiltrates. Despite broad-spectrum coverage the patient developed severe hypoxemia and was intubated for acute respiratory failure. Workup including Legionella urine antigen, respiratory cultures, bronchoscopy with BAL was negative; further delaying the diagnosis. Serial Xrays continued to show worsening multifocal pneumonia. CT chest then performed revealed…
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