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Infectious Disorders - Drug Targets

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ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

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Case Report

Legionella pneumophila Pneumonia in Pregnancy: A Case Report and Review of the Literature

Author(s): Katherine A. Kleinberg and Suresh J. Antony*

Volume 20, Issue 2, 2020

Page: [247 - 252] Pages: 6

DOI: 10.2174/1871526519666190119110657

Price: $65

Abstract

L. pneumophila is an unusual cause of pneumonia with a prevalence of 2.7%, and it is even more uncommon in pregnancy. To date, only 11 cases of Legionnaire’s Disease in pregnancy have been reported, though this small number could possibly be attributed to underdiagnoses and under documentation.

Case Presentation: In this paper, we present a 31-year-old Hispanic female, gravida 4, para 1 from the southwest United States who presented with a 3-week history of fever, worsening cough, dyspnea on exertion, and hypoxemia. Chest x-ray showed bibasilar infiltrates, with positive serology for Legionella IgM and IgG (1:250 and 1:640 respectively), as well as positive urinary antigen. Despite appropriate treatment with azithromycin 500 mg, she continued to have dyspnea and mild respiratory distress.

Conclusion: Upon follow up, mother and fetus initially remained stable without any signs of sequelae from Legionnaire’s disease, but the patient miscarried 5 weeks after the second admission to the hospital. The chest x-ray eventually cleared up after almost 21 days of azithromycin.

Keywords: Legionnaire's Disease, Legionella pneumophila, pneumonia, pregnancy, antigen, azithromycin.

Graphical Abstract

[1]
Marchello, C.; Dale, A.P.; Thai, T.N.; Han, D.S.; Ebell, M.H. Prevalence of Atypical Pathogens in Patients With Cough and Community-Acquired Pneumonia: A Meta-Analysis. Ann. Fam.Med.,, 2016, 14(6), 552-566.
[http://dx.doi.org/10.1370/afm. 1993] [PMID: 28376442]
[2]
Baker, D.A.; Phillips, C.A. Association of Legionnaires’ disease and pregnancy. Am. J. Obstet. Gynecol., 1979, 134(2), 227-228.
[http://dx.doi.org/10.1016/0002-9378(79)90891-3] [PMID: 453252]
[3]
Soper, D.E.; Melone, P.J.; Conover, W.B. Legionnaire disease complicating pregnancy. Int. J. Gynaecol. Obstet., 1987, 25(1), 82-82.
[http://dx.doi.org/10.1016/0020-7292(87)90214-1]
[4]
Eisenberg, V.H.; Eidelman, L.A.; Arbel, R.; Ezra, Y. Legionnaire’s disease during pregnancy: a case presentation and review of the literature. Eur. J. Obstet. Gynecol. Reprod. Biol., 1997, 72(1), 15-18.
[http://dx.doi.org/10.1016/S0301-2115(96)02648-6] [PMID: 9076416]
[5]
Tewari, K.; Wold, S.M.; Asrat, T. Septic shock in pregnancy associated with legionella pneumonia: case report. Am. J. Obstet. Gynecol., 1997, 176(3), 706-707.
[http://dx.doi.org/10.1016/S0002-9378(97)70573-8] [PMID: 9077632]
[6]
Vimercati, A.; Greco, P.; Bettocchi, S.; Resta, L.; Selvaggi, L. Legionnaire’s disease complicating pregnancy: a case report with intrauterine fetal demise. J. Perinat. Med., 2000, 28(2), 147-150.
[http://dx.doi.org/10.1515/JPM.2000.020] [PMID: 10875101]
[7]
Gaillac, N.; Floccard, B.; Ould, T.; Benatir, F.; Levrat, A.; Meunier, P.; Allaouchiche, B. Legionella pneumophila pneumonia during pregnancy: a case report. J. Infect., 2006, 52(6), e163-e164.
[http://dx.doi.org/10.1016/j.jinf.2005.08.033] [PMID: 16246423]
[8]
Epping, G.; van der Valk, P.D.L.P.M.; Hendrix, R. Legionella pneumophila pneumonia in a pregnant woman treated with anti-TNF-α antibodies for Crohn’s disease: a case report. J. Crohn’s Colitis, 2010, 4(6), 687-689.
[http://dx.doi.org/10.1016/j.crohns.2010.08.006] [PMID: 21122583]
[9]
Xu, J.; Odibo, I.N.; Eastham, D.G.; Dajani, N.K. Legionella Infection in Pregnancy: The Forgotten Pathogen in Septic Shock. Obstet. Gynecol., 2015, 126(5), 1085-1087.
[http://dx.doi.org/10.1097/AOG.0000000000001054] [PMID: 26375712]
[10]
Close, A.; Gimovsky, A.; Macri, C. Adult Respiratory Distress Disorder Due to Legionnaires Disease in Pregnancy: A Case Report. J. Reprod. Med., 2016, 61(1-2), 83-86.
[PMID: 26995895]
[11]
Oostwoud, D.W.; Achterberg, S.; Savelkoul, C. A severe community-acquired pneumonia during pregnancy. Netherlands Journal of Critical Care., 2017, 25(5), 178-182.
[12]
Cilloniz, C.; Torres, A. Typical Presentation of Legionella pneumophila Community-Acquired Pneumonia. Revista Portuguesa de Pneumologia (English Edition).,, 2017, 23(3), 115-116.
[http://dx.doi.org/10.1016/j.rppnen.2017.04.001]
[13]
Morgan, A.J.; Glossop, A.J. Severe community-acquired pneumonia. BJA Educ., 2015, 16(5), 167-172.
[http://dx.doi.org/10.1093/bjaed/mkv052]
[14]
Annamraju, H.; Mackillop, L. Respiratory disease in pregnancy. Obstetrics, Gynaecol. Reprod. Med., 2017, 27(4), 105-111.
[http://dx.doi.org/10.1016/j.ogrm.2017.01.011]
[15]
Mandell, L.A.; Wunderink, R. Pneumonia.Harrison’s Principles of Internal Medicine, 20e New York; Jameson, J.; Fauci, A.S.; Kasper,D.L.; Hauser, S.L.; Longo, D.L.; Loscalzo, J., Eds.; http://accessmedicine.mhmedical.com.ezproxy.ad.bcomnm.org/content.aspx?bookid=2129&sectionid=184041853
[16]
Arnold, F.W.; Summersgill, J.T.; Ramirez, J.A. Role of Atypical Pathogens in the Etiology of Community-Acquired Pneumonia. Semin. Respir. Crit. Care Med., 2016, 37(6), 819-828.
[http://dx.doi.org/10.1055/s-0036-1592121] [PMID: 27960206]
[17]
Miyashita, N.; Higa, F.; Aoki, Y.; Kikuchi, T.; Seki, M.; Tateda, K.; Maki, N.; Uchino, K.; Ogasawara, K.; Kiyota, H.; Watanabe, A. Clinical presentation of Legionella pneumonia: Evaluation of clinical scoring systems and therapeutic efficacy. J. Infect. Chemother., 2017, 23(11), 727-732.
[http://dx.doi.org/10.1016/j.jiac.2017.09.001] [PMID: 28951197]

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