Article Text

Reminder of important clinical lesson
A patient with Legionnaires’ disease transferred after a traffic accident
  1. Ryota Sakamoto1,
  2. Akira Ohno2,
  3. Toshitaka Nakahara1,
  4. Kazunari Satomura1,
  5. Suketaka Iwanaga1,
  6. Masahiko Saito3,
  7. Kiyohito Okumiya4,
  8. Keizo Yamaguchi2
  1. 1
    Kyoto University, Department of Public Health, Yoshidakonoecho, Sakyoku, Kyoto, 606–8501, Japan
  2. 2
    Toho University School of Medicine, Department of Microbiology and Infectious Diseases, 5-21-16, Omorinishi, Ohtaku, Tokyo, 143-0015, Japan
  3. 3
    Ujitokushukai Hospital, 86, Kasugamori, Oguracho, Uji, 611-0042, Japan
  4. 4
    Research Institute for Humanity and Nature, 457–4, Motoyama, Kamigamo, Kitaku, Kyoto, 606–8047, Japan
  1. Ryota Sakamoto, sakamoto65{at}chikyu.ac.jp

Summary

Legionnaires’ disease (LD) ranks among the three most common causes of severe pneumonia, but is often not specifically diagnosed. Among patients with LD, 40% to 50% of the patients develop neuromuscular signs and symptoms. A patient with LD transferred to our department after a traffic accident. When the patient arrived at our hospital, his respiratory rate was 27 breaths per min. His pulse was 148 beats per min and blood pressure was 116/57 mm Hg. Temperature was 39.6°C. He had copious watery diarrhoea and had been diagnosed as having acute gastroenteritis. The patient had urinary incontinence, gait disturbance, mild headache, fatigue and excessive decrease in spontaneous speech. A urinary antigen test for Legionella pneumophila turned out to be positive. LD commonly involves the neuromuscular system. Although this may be an atypical case of LD, it implies the need for awareness of LD.

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Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication.

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