Abstract
IntroductionLegionella pneumonia can appear with different levels of severity and it can often present with complications such as acute respiratory distress syndrome.Case presentationWe report the case of a 44-year-old Caucasian man with Legionella pneumonia with successive development of severe acute respiratory distress syndrome. During his stay in intensive care the clinical and radiological situation of the previously observed acute respiratory distress syndrome unexpectedly worsened due to acute pulmonary eosinophilic infiltrate of iatrogenic origin.ConclusionLevofloxacin treatment caused the occurrence of acute eosinophilic infiltrate. Diagnosis was possible following bronchoscopic examination using bronchoaspirate and transbronchial biopsy.
Highlights
Legionella pneumonia can appear with different levels of severity and it can often present with complications such as acute respiratory distress syndrome.Case presentation: We report the case of a 44-year-old Caucasian man with Legionella pneumonia with successive development of severe acute respiratory distress syndrome
A significant number of drugs used in the treatment of Legionella pneumonia can be associated with the appearance of pulmonary eosinophilic infiltrates, especially non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics [3]
This report concerns the case of a man with Legionella pneumonia that evolved into acute respiratory distress syndrome (ARDS) and became complicated with eosinophilic infiltration as an effect of treatment with levofloxacin
Summary
Since the pneumonia epidemic that struck the delegates of the American Legion Convention in Philadelphia in 1976, Legionella spp. has become a relatively frequent cause of community acquired pneumonia [1]. This report concerns the case of a man with Legionella pneumonia that evolved into ARDS and became complicated with eosinophilic infiltration as an effect of treatment with levofloxacin. The results of initial laboratory examinations revealed his white blood cell count was 2020 cells/mm, total bilirubin level was (1.6 mg/dL), he had reduced albuminemia (2.7 g/dL), increased alkaline phosphatase (382 U/L), g-glutamyl transferase (69 U/L) and creatine phosphokinase (422 U/L) His serology test results were negative for Hepatitis B virus, Hepatitis C virus and HIV. On the 27th day, his steroid therapy was increased (methylprednisolone 1 g/day) while levofloxacin was suspended His response to steroid therapy was rapid, with a general improvement starting from the fifth day of treatment (the 32nd day overall), associated with accompanying improvement of respiratory exchange and subsequent return to spontaneous breathing on the 41st day (PaO2/FiO2 ratio of 357). On the 51st day, a chest X-ray showed that the pneumonia bilateral consolidation had completely resolved (Figure 4)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
