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Case report
Transient parkinsonism associated with acute Legionnaires’ disease
  1. Johnny S Su1,
  2. Steven Honsberger2 and
  3. Muhammad G Husnain2
  1. 1School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
  2. 2MetroHealth Medical Center, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
  1. Correspondence to Dr Muhammad G Husnain; husnainmg82{at}gmail.com

Abstract

A 44-year-old right-handed man with a 5-day history of non-productive cough associated with subjective fevers/chills and night sweats presented to the emergency department with slurred speech. Radiography and urine antigen testing confirmed the diagnosis of Legionella pneumonia. The hospital course was complicated by acute hypoxic respiratory failure that required 7 days of invasive mechanical ventilation. Following extubation, the patient had dysarthria and developed new parkinsonism features. Brain imaging revealed a non-specific focal lesion in the left frontal lobe of unclear significance. Ciprofloxacin was decided as the final antibiotic of choice for its favourable central nervous system profile. Levodopa–carbidopa was initiated to help activate the basal ganglia. The patient had complete resolution of pneumonia and transient parkinsonism. He was able to regain most of his baseline functional status with intensive rehabilitation.

  • neurology (drugs and medicines)
  • pneumonia (infectious disease)
  • movement disorders (other than Parkinsons)
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Footnotes

  • Contributors All authors were involved in the direct care of the patient and conceived the idea of writing a case report. JSS and SH wrote the case presentation, performed a literature review and wrote the discussion of the manuscript. MGH substantially reviewed the whole manuscript and updated essential intellectual content. All authors read the manuscript and approved it for submission in its current form.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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