Abstract
The causative agent of legionellosis is the Gram-negative intracellular bacteria Legionella spp. Its clinical presentation varies from a mild febrile illness called Pontiac fever to the severe and possible fatal pneumonia, Legionnaires’ disease. Immunocompromised patients, in particular, are affected. Only a small number of infected neonates are described in the literature. Most of them have been associated with water birth or the use of air humidifiers. In the last five years, a growing number of cases have been reported in Germany by the national institute of disease surveillance and prevention (Robert-Koch Institute). Here, we describe a fatal case report of pulmonary legionellosis with acute respiratory distress syndrome (ARDS), sepsis, associated cutaneous manifestation, and extracorporeal membrane oxygenation in a full-term neonate. Moreover, we present a review of the literature discussing the epidemiology, risk factors, clinical features, diagnostics, treatment options, and prevention for this rare condition in neonates.
Highlights
Respiratory tract infections in neonates have a significant impact on morbidity and mortality in this fragile patient population
We present a review of the literature discussing the epidemiology, risk factors, clinical features, diagnostics, treatment options, and prevention for this rare condition in neonates
The incubation period of Legionella pneumonia is roughly 2 to 14 days [1]. Most of these infections are of nosocomial origin and associated to contaminated water at various stages of a newborn’s hospitalization, from the delivery room environment, the pool water for water births [2], to sinks [3] or humidifier of the maternity ward [4], to the setting of a neonatal intensive care unit (NICU), predominantly the humidifier of incubators [5]
Summary
Respiratory tract infections in neonates have a significant impact on morbidity and mortality in this fragile patient population. They may be infected in utero, during labor and delivery, or postnatally. The incubation period of Legionella pneumonia is roughly 2 to 14 days [1] Most of these infections are of nosocomial origin and associated to contaminated water at various stages of a newborn’s hospitalization, from the delivery room environment, the pool water for water births [2], to sinks [3] or humidifier of the maternity ward [4], to the setting of a neonatal intensive care unit (NICU), predominantly the humidifier of incubators [5]. We present a review of the literature discussing the epidemiology, risk factors, clinical features, diagnostics, treatment options, and prevention for this rare condition in neonates
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