The spectrum of legionnaires' disease: a case series illustrating clinical diversity and outcomes
Abstract
BACKGROUND: Legionella pneumophila causes Legionnaires' disease, a severe atypical pneumonia with variable clinical presentation and significant morbidity and mortality. The Centers for Disease Control and Prevention reports that Legionnaires' disease incidence has steadily increased since the early 2000s. Despite over 40 years of recognition, clinical awareness remains suboptimal.
CASE DESCRIPTION: We present five patients with confirmed Legionnaires' disease in a community hospital setting. Patients' ages ranged from 38 to 83 years old with varied comorbidities. Clinical presentations included respiratory symptoms (cough, dyspnea), systemic manifestations (fever, fatigue, malaise), and extrapulmonary features (diarrhea, hyponatremia). Hyponatremia was present in 40% of the cohort. Chest imaging revealed unilateral or bilateral infiltrates. Diagnosis was confirmed via urinary antigen testing detecting Legionella pneumophila serogroup 1. Duration of hospitalization ranged from 3 to 10 days. Four patients were successfully treated with levofloxacin or azithromycin and discharged; one patient with multiple comorbidities died from septic and cardiogenic shock despite appropriate antimicrobial therapy.
CONCLUSIONS: This case series reinforces the variable clinical presentation of Legionnaires' disease and emphasizes the critical importance of clinical suspicion in patients with atypical pneumonia, particularly those with risk factors including advanced age, comorbidities, or…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- GC-MS Analysis and Biomedical Therapy of Oil from n-Hexane Fraction of Scutellaria edelbergii Rech. f.: In Vitro, In Vivo, and In Silico Approach
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.