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12 July 2022 : Case report  Japan

Clinical Presentation of Legionella pneumophila Serogroup 1-Associated Pneumonia and Diffuse Alveolar Hemorrhage: A Case Report and Literature Review

Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Kazuhiro Ishikawa1ABCDEF*, Tomoaki Nakamura ORCID logo2CDF, Takahiro Matsuo1AD, Fujimi Kawai ORCID logo3F, Hinako Murakami4B, Kotaro Aoki5B, Tatsuya Nagasawa5B, Yuki Uehara1678DE, Nobuyoshi Mori1ABCDEF

DOI: 10.12659/AJCR.936309

Am J Case Rep 2022; 23:e936309

Supplementary Table 2. Clinical characteristics of previously reported cases of diffuse alveolar hemorrhage resulting from Legionella spp. infection.

ReferenceAgeSexPublication year/CountryUnderlying conditionAerosol exposureDiagnosis for AH/pathogen
1Chowdhur et al []7 67F2020/USACrohn’s disease on azathioprineN/ABAL/BAL PCR, culture
2Pataka et al []11 75M2018/GreeceHTNN/ABAL/urinary antigen
3Kashif et al []8 61M2017/USAHTN, DL, type 2 DM, obesityN/ABAL/urinary antigen
4Sundar and Pearce []9 57F2004/USAPCT, HCV, GERD, heavy smoking for 30 yearsN/ABAL/BAL PCR, culture, urinary antigen
5Marruchella and Franco []10 47F2003/ItalyMSN/ABAL/urinary antigen
6Present case44F2021/JapanSLE, SS, EBV retinitis and optic nephritis, on steroidYesBAL/BAL PCR, sputum culture
M – male; F – female; HTN – hypertension; type 2 DM – type 2 diabetes mellitus; SLE – systemic erythematous; SS – Sjögren’s syndrome; PCR – polymerase chain reaction; BAL – bronchoalveolar lavage; LVFX – levofloxacin; DOXY – doxycycline; AZM – azithromycin; SG – serogroup; PCT – porphyria cutanea tarda; HCV – hepatitis C; N/A – not applicable; MS – mitral valve stenosis; CAZ – ceftazidime; HTN – hypertension; MFLX – moxifloxacin; AH – alveolar hemorrhage; DL – dyslipidemia; PR3-ANCA – proteinase 3-antineutrophil cytoplasmic antibody.
ReferenceChief complaintSGABX for LegionellaSteroid useMechanical intubationPrognosis
1Chowdhur et al []7 Fever, appetite loss, fatigue, dizziness, cough3AZM, DOXY (AZM discontinued due to persistently prolonged QTc)YesYesCured
2Pataka et al []11 Fever, myalgia, dyspnea1MFLXYes/PR3-ANCA (+)YesUnresponsive to the treatment
3Kashif et al []8 Progressive dyspnea, acute cough, production of yellowish sputum, feverN/AAZM+LVFX for 21 daysYesYesCured
4Sundar and Pearce []9 Progressive dyspnea, fever, bloody sputumN/AAZMYesYesCured
5Marruchella and Franco []10 Fever, worsening dyspnea, pleuritic chest pain1CAM+RFPN/AYesCured
6Present caseDyspnea1LVFX for 14 daysYesNoCured
M – male; F – female; HTN – hypertension; type 2 DM – type 2 diabetes mellitus; SLE – systemic erythematous; SS – Sjögren’s syndrome; PCR – polymerase chain reaction; BAL – bronchoalveolar lavage; LVFX – levofloxacin; DOXY – doxycycline; AZM – azithromycin; SG – serogroup; PCT – porphyria cutanea tarda; HCV – hepatitis C; N/A – not applicable; MS – mitral valve stenosis; CAZ – ceftazidime; HTN – hypertension; MFLX – moxifloxacin; AH – alveolar hemorrhage; DL – dyslipidemia; PR3-ANCA – proteinase 3-antineutrophil cytoplasmic antibody.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923