Abu Noem Farooqui, Aftab Merchant, Arshad H Merchant.
A Case Report of Unusual Complications Legionnaires Disease with pertinent review of literature.
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Jan ;5:223-7.

We report the case of a 18 year old fisherman who initially presented with high grade fever with rigors and unconsciousness with a clear X-ray chest. He did not responded to empirical therapy directed towards infections of nervous system. On the second day of hospitalization he developed fever. His chest radiograph showed pulmonary infiltrates on third day. At this stage Legionnaires` disease was considered in the differentials. Labs were requested that supported the diagnosis. Erythromycin was administered and the patient regained full consciousness by third day and was completely well within a week. In this case the neurological manifestations of this disease preceded the development of pulmonary infiltrates, which is a very unusual presentation. The occurrence of grand mal seizure In this case was also a unique feature. The diagnosis of legionellosis requires special tests not routinely performed on persons with fever or pneumonia. Therefore, a physician must consider the possibility of legionellosis in order to obtain appropriate tests. We focus the importance of this etiology in community-acquired pneumonia and the need to include this entity in the differential diagnosis of all pneumoniae with multi-visceral involvement, and atypical and aggressive presentations.

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