VA Resident Report: What is the relationship between legionella and cavitary lung lesions?

Cavitary legionella pneumonia is an uncommon finding in immunocompetent patients, and has been commonly reported in immunosuppressed patients. In this study, this is almost identical to the authors’ finding of cavitary consolidation in 4 patients treated with high-dose steroid therapy. Especially in 3 patients on high-dose steroid pulse therapy, radiological findings such as rapidly enlarged dense lobar consolidation followed by cavitation were remarkably consistent, regardless of the various underlying diseases, which concurs with a previous report on legionella pneumonia in renal transplant patients.

Kim, Kyung Won, Goo, Jin Mo, Lee, Hyun Ju, Lee, Ho Yun, Park, Chang Min, Lee, Chang Hyun, & Im, Jung-Gi. (n.d.). Chest computed tomographic findings and clinical features of legionella pneumonia. Journal of Computer Assisted Tomography, 31(6), 950-955.

The common clinical problem faced during the management of pneumonia is the differentiation of legionella pneumonia from other atypical and typical pneumonia. Because legionella pneumonia occurs in immunocompromised hosts with various underlying diseases, rapid diagnosis and early initiation of appropriate treatment based on antilegionella antibiotics is required for a good clinical outcome

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