Legionella pulmonary abscess and pleural space infection in an immunocompetent patient.

Autor: Flint KL; Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA kflint@bidmc.harvard.edu.; Harvard Medical School, Boston, MA, USA., Lloyd MR; Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., van den Berg P; Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Kanjee Z; Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: BMJ case reports [BMJ Case Rep] 2021 May 24; Vol. 14 (5). Date of Electronic Publication: 2021 May 24.
DOI: 10.1136/bcr-2021-243026
Abstrakt: A 34-year-old woman is admitted to the hospital with dyspnoea, dry cough and left-sided flank pain. Her Legionella urinary test was positive and CT imaging demonstrated multifocal pneumonia with pulmonary abscesses. Although she had initial clinical improvement on appropriate antibiotic therapy, her hospital course was complicated by worsening flank pain, hypoxemia and leucocytosis, prompting clinical re-evaluation and assessment for development of complications involving the pleural space. CT imaging revealed interval development of a loculated complicated parapneumonic effusion. Successful treatment required chest tube drainage assisted by fibrinolytic therapy. This case highlights the importance of considering Legionella in patients with pulmonary abscess, demonstrates an approach to a patient with a non-resolving pneumonia and illustrates the management of parapneumonic effusions.
Competing Interests: Competing interests: ZK serves on a paid advisory board for Wolters Kluwer and receives royalties from Wolters Kluwer for medical books he edited. There are no competing interests for any other authors.
(© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze: MEDLINE
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