What is the role of radiography in the diagnosis of Legionnaires disease?

Updated: Mar 11, 2021
  • Author: Chinelo N Animalu, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Legionella infection almost always produces an abnormal chest radiographic finding, with the abnormalities typically being unilateral and occurring in the lower lobes. However, the abnormalities are variable and may be focal or diffuse; no typical radiographic presentation exists for LD. [15]

Rapidly progressive, asymmetrical infiltrates are nonetheless characteristic of the disease. Chest radiography often shows patchy alveolar infiltrates with consolidation in the lower lobe (although all lobes may be affected). Progression of the infiltrates may be seen despite antibiotic therapy. Up to 50% of patients have a pleural effusion. Cavity and abscess formation are rare in LD but can occur in immunocompromised hosts.

Improvement revealed on chest radiography can lag behind clinical improvement by 5-7 days; the radiographic abnormalities can take up to 3-4 months to resolve completely.

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