28 December 2019 : Case report
Challenging differential diagnosis, Rare coexistence of disease or pathologyHany K. Mosaad-Boktor1E*, Stephen A. Lee1BEF
Am J Case Rep 2019; 20:1956-1960
BACKGROUND: Legionella pneumonia can be an aggressive form of pneumonia. However, it is rare in pregnant women, particularly in the peripartum period. To the best of our knowledge this is the only case of Legionella pneumonia with endometrial sepsis. We are reporting a patient with this rare condition.
CASE REPORT: The patient was an 18-year-old female, pregnant with her first baby, who developed symptoms of the common cold near term. The patient was seen at another major facility initially and was discharged home with a diagnosis of “cold”. She was still uncomfortable and came to our facility Aront Ogden Medical Center Elmira, NY, USA, where she had rupture of membranes and underwent C-section. She was suspected clinically of having pneumonia. Initial chest x-ray was negative, but computed tomography (CT)-scan did show bilateral pneumonia. Further workup confirmed the diagnosis of Legionella pneumonia and was treated for that as well as for endometritis. She did require Intensive Care Unit (ICU) care during her hospital stay. The patient was seen and evaluated by multiple subspecialties, including Critical Care, Infectious Disease, and Gastroenterology subspecialties. The patient improved steadily, and was later discharged home in the care of her family with a healthy baby and was advised to follow up with her Primary Medical Provider as outpatient.
CONCLUSIONS: Legionella pneumonia in pregnancy may be more common than we think, and could be easily overlooked in that patient population, have to be in the back mind of medical provider. Overlooking diagnosis could lead to serious adverse consequences for these patients.
Keywords: Legionnaires' Disease, Pneumonia, Pregnancy, Sepsis, Adolescent, common cold, Diagnostic Errors, Pneumonia, Bacterial, Pregnancy Complications, Infectious, Tomography, X-Ray Computed
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