Spretz Matthew W, Orrukem Martin M, Khwaja Bisma, Karnath Bernard
Internal Medicine, University of Texas Medical Branch, Galveston, USA.
Cureus. 2024 May 9;16(5):e59979. doi: 10.7759/cureus.59979. eCollection 2024 May.
Legionnaires' disease is a potentially severe type of pneumonia most often caused by the organism . Exposure to this bacterial pathogen typically happens in the community but may also occur in the hospital setting. This report describes the case of a patient who presented due to 10 days of fever, shortness of breath, and diarrhea, with initial imaging demonstrating multifocal pneumonia. The patient was appropriately started on empiric antibiotics for community-acquired pneumonia and admitted to the medicine floor. The patient showed no meaningful improvement in his initial hospital course on empiric antibiotics with continued oxygen requirements. Meanwhile, urine Legionella antigen testing returned positive on hospital day four, and after tailoring antibiotics accordingly, the patient's clinical status improved significantly. This case report highlights the efficacy of broad testing in the initial admission and the need for constant re-evaluation in the context of a patient not improving with appropriate therapy.
军团病是一种潜在的严重肺炎类型，最常见的病因是该病原体。接触这种细菌病原体通常发生在社区，但也可能发生在医院环境中。本报告描述了一名患者的病例，该患者因持续10天的发热、呼吸急促和腹泻就诊，初始影像学显示为多灶性肺炎。患者开始接受经验性抗生素治疗社区获得性肺炎，并入住内科病房。患者在接受经验性抗生素治疗的初始住院过程中没有明显改善，仍持续需要吸氧。与此同时，尿嗜肺军团菌抗原检测在住院第4天呈阳性，在相应调整抗生素治疗后，患者的临床状况显著改善。本病例报告强调了入院初期进行广泛检测的有效性，以及在患者接受适当治疗后病情无改善的情况下持续重新评估的必要性。
