Which extrapulmonary findings suggest Legionella pneumophila community-acquired pneumonia (CAP) (Legionnaires disease)?

Updated: Oct 31, 2019
  • Author: Stephanie L Baer, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Legionella pneumophila CAP (Legionnaires disease) is associated with the following findings: [49]

  • Gastrointestinal and neurologic symptoms in the setting of pneumonia
  • Positive history of water or travel exposure
  • Relative bradycardia during febrile episode
  • Hyponatremia, hypophosphatemia, elevated creatine phosphokinase (CPK) level, elevated ferritin level, myoglobinuria
  • Leukocytosis with relative lymphopenia
  • Unresponsive to beta-lactam antibiotics
A case of Legionnaires disease from the Philadelph A case of Legionnaires disease from the Philadelphia outbreak, showing characteristics of relative bradycardia and extrapulmonary involvement.
This graph outlines a case of Legionella pneumonia This graph outlines a case of Legionella pneumonia, showing characteristics of bradycardia and extrapulmonary involvement. Also shown is an initial lack of response to beta-lactam antibiotics, followed by effective treatment with doxycycline.

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