Legionella pneumonia
| 8% of severe CAP, with encephalopathy, LFT derangement, bradycardia, diarrhoea and acute kidney injury. | |
|---|---|
| Etiology | Legionella pneumophilia - obligate aerobe, Gram negative rod |
| Epidemiology | outbreaks including within hospitals seasonal pattern 2-10 day incubation |
| Symptoms | Fever, productive cough, pleuritic chest pain CNS: GBS, ADEM GI: diarrhoea |
| Diagnosis and investigations | Diagnostic: urinary antigen (false positive with other Gram neg bacteria) Also: culture (gold standard), immunofluorescence of respiratory specimens Serology not very helpful |
| Signs: | Hyponatraemia GI: deranged LFTs Renal: rhabdo, AKI |
| Radiology | Lobar consolidation with rapid progression "ground-glass opacification that may have a subtle crazy-paving appearance" - septal thickening |
| Management: | Fluoroquinolones eg levofloxacin, macrolides |