Legionella pulmonary abscess and pleural space infection in an immunocompetent patient.
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.
['Flint|Kristen L|KL|http://orcid.org/0000-0001-6941-9385', 'Lloyd|Maxwell R|MR|http://orcid.org/0000-0001-9810-0437', 'van den Berg|Polly|P|http://orcid.org/0000-0002-2918-3045', 'Kanjee|Zahir|Z|http://orcid.org/0000-0001-9287-4503']
D000328:Adult D015505:Chest Tubes D004322:Drainage D016724:Empyema, Pleural D005260:Female D006801:Humans D007875:Legionella D008169:Lung Abscess D010996:Pleural Effusion D011014:Pneumonia
pleural infection pneumonia (infectious disease) pneumonia (respiratory medicine)