Guo Zihan, Zuo Anli, Liu Xinyi, Jiang Yunxiu, Yang Shuran, Lu Degan
Department of Respiratory, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Institute of Respiratory Diseases, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, China.
Front Med (Lausanne). 2024 Feb 27;11:1329381. doi: 10.3389/fmed.2024.1329381. eCollection 2024.
Legionella pneumonia (LP) is a relatively uncommon yet well-known type of atypical community-acquired pneumonia (CAP). It is characterized by a rapid progression to severe pneumonia and can be easily misdiagnosed. In most patients, chest computed tomography (CT) showed patchy infiltration, which may progress to lobar infiltration or even lobar consolidation. While pulmonary cavities are commonly observed in immunocompromised patients with LP, they are considered rare in immunocompetent individuals. Herein, we present a case of LP in an immunocompetent patient with multiple cavities in both lungs. Pathogen detection was performed using metagenomic next-generation sequencing (mNGS). This case highlights the unusual radiographic presentation of LP in an immunocompetent patient and emphasizes the importance of considering LP as a possible diagnosis in patients with pulmonary cavities, regardless of their immune status. Furthermore, the timely utilization of mNGS is crucial for early pathogen identification, as it provides multiple benefits in enhancing the diagnosis and prognosis of LP patients.
军团菌肺炎（LP）是一种相对不常见但广为人知的非典型社区获得性肺炎（CAP）。其特点是迅速进展为重症肺炎，且容易误诊。大多数患者胸部计算机断层扫描（CT）显示斑片状浸润，可进展为大叶性浸润甚至大叶实变。虽然在免疫功能低下的LP患者中常见肺空洞，但在免疫功能正常的个体中被认为少见。在此，我们报告一例免疫功能正常的患者发生LP且双肺出现多个空洞的病例。使用宏基因组下一代测序（mNGS）进行病原体检测。该病例突出了免疫功能正常患者中LP不寻常的影像学表现，并强调了无论患者免疫状态如何，对于有肺空洞的患者考虑LP作为可能诊断的重要性。此外，及时使用mNGS对于早期病原体鉴定至关重要，因为它在改善LP患者的诊断和预后方面具有多种益处。
