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    Legionnaires’ disease presenting with exanthem; Case and review of previously published cases

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    Author
    Carter, Christine J.
    Corley, Elizabeth M.
    Canepa, Hannah
    Schmalzle, Sarah A.
    Date
    2022-01-01
    Journal
    IDCases
    Publisher
    Elsevier
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.idcr.2022.e01376
    Abstract
    Infection with Legionella spp. (legionellosis) causes two distinct clinical presentations: Legionnaires’ Disease and Pontiac Fever. Legionnaire's Disease primarily involves the lungs, often with accompanying gastrointestinal symptoms, and can also affect the liver, central nervous system, and kidneys, and cause metabolic derangements. Manifestations in the integumentary system are rare; to date, there have been eleven cases reported in the literature of Legionellosis with associated rash, with varied presentation. The relationship between Legionella pneumophila and the skin has not yet been clearly defined; immunological and/or toxic pathogenesis are possible. We report a case of Legionnaires’ Disease in a young immunocompromised man with a largely benign clinical course consisting of predominantly gastrointestinal symptoms and an extensive maculopapular rash. Chest radiography showed lobar infiltrate in the absence of clinical symptoms of pneumonia. The importance of this case is for clinicians to maintain high clinical suspicion for Legionella when extra-pulmonary symptoms predominate, specifically in immunocompromised hosts who may have atypical presentations and have higher mortality rates when treatment is delayed. © 2022 The Authors
    Keyword
    Immunosuppression
    Legionnaire's Disease
    Rash
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17631
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.idcr.2022.e01376
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