Legionella and mycoplasma pneumonia--a community hospital experience with atypical pneumonias.

The clinician should be alert to the possibility of Legionella pneumonia in the community hospital setting. Importantly, degree of suspicion, that is, familiarity with extrapulmonary clinical and laboratory features of the typical pneumonias, nearly always leads to a correct presumptive diagnosis that may later be confirmed by serologic testing. Serologic testing has confirmed only a minority of cases. Since early empiric therapy is critical to survival in many of these patients, knowing how to arrive at a presumptive diagnosis based upon the clinical clue present or absent is essential in the community hospital setting.