Community-acquired pneumonia due to Legionella pneumophila, a rare entity in Ecuador. Bibliographic review and case report.

Abstract

Legionnaires' disease is one of the multiple forms of presentation of Legionella pneumophila infection, which can range from a mild cough to fatal pneumonia, with a mortality rate ranging from 22 to 54%. Its real incidence is unknown due to underdiagnosis and lack of tools in developing countries. Inadequate or late antibiotic treatment in Legionella pneumonia has been associated with a worse prognosis. Hence the importance of clinical suspicion, diagnosis and timely treatment. The case of a foreign patient, resident in Australia, is presented who, after traveling through several South American countries, presents with respiratory symptoms of 7 days of evolution, combined with general condition, respiratory failure in the initial evaluation. Chest tomography showed evidence of pneumonic consolidation with trilobar air bronchogram. In the patient's context, empirical treatment was administered based on oral levofloxacin and systemic steroids with favorable clinical evolution. Finally, the diagnosis is confirmed with a positive polymerase chain reaction (PCR) result for Legionella pneumophila in the blood.