12 July 2022 : Case report
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 2CDF, Takahiro Matsuo1AD, Fujimi Kawai 3F, Hinako Murakami4B, Kotaro Aoki5B, Tatsuya Nagasawa5B, Yuki Uehara1678DE, Nobuyoshi Mori1ABCDEFDOI: 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.
Reference | Age | Sex | Publication year/Country | Underlying condition | Aerosol exposure | Diagnosis for AH/pathogen | |
---|---|---|---|---|---|---|---|
1 | Chowdhur et al []7 | 67 | F | 2020/USA | Crohn’s disease on azathioprine | N/A | BAL/BAL PCR, culture |
2 | Pataka et al []11 | 75 | M | 2018/Greece | HTN | N/A | BAL/urinary antigen |
3 | Kashif et al []8 | 61 | M | 2017/USA | HTN, DL, type 2 DM, obesity | N/A | BAL/urinary antigen |
4 | Sundar and Pearce []9 | 57 | F | 2004/USA | PCT, HCV, GERD, heavy smoking for 30 years | N/A | BAL/BAL PCR, culture, urinary antigen |
5 | Marruchella and Franco []10 | 47 | F | 2003/Italy | MS | N/A | BAL/urinary antigen |
6 | Present case | 44 | F | 2021/Japan | SLE, SS, EBV retinitis and optic nephritis, on steroid | Yes | BAL/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. | |||||||
Reference | Chief complaint | SG | ABX for Legionella | Steroid use | Mechanical intubation | Prognosis | |
1 | Chowdhur et al []7 | Fever, appetite loss, fatigue, dizziness, cough | 3 | AZM, DOXY (AZM discontinued due to persistently prolonged QTc) | Yes | Yes | Cured |
2 | Pataka et al []11 | Fever, myalgia, dyspnea | 1 | MFLX | Yes/PR3-ANCA (+) | Yes | Unresponsive to the treatment |
3 | Kashif et al []8 | Progressive dyspnea, acute cough, production of yellowish sputum, fever | N/A | AZM+LVFX for 21 days | Yes | Yes | Cured |
4 | Sundar and Pearce []9 | Progressive dyspnea, fever, bloody sputum | N/A | AZM | Yes | Yes | Cured |
5 | Marruchella and Franco []10 | Fever, worsening dyspnea, pleuritic chest pain | 1 | CAM+RFP | N/A | Yes | Cured |
6 | Present case | Dyspnea | 1 | LVFX for 14 days | Yes | No | Cured |
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. |