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Case Reports
. 2017 Dec 5:5:2050313X17744981.
doi: 10.1177/2050313X17744981. eCollection 2017.

A case of legionella pneumonia caused by home use of continuous positive airway pressure

Ruby Schnirman  1 , Nasifa Nur  1 , Alice Bonitati  1 , Gerardo Carino  1
Affiliations
Case Reports

A case of legionella pneumonia caused by home use of continuous positive airway pressure

Ruby Schnirman et al. SAGE Open Med Case Rep. .

Abstract

A 67-year-old woman with morbid obesity and severe obstructive sleep apnea presented to the emergency department with 2 days of productive cough, fever, shortness of breath and loose stools. A chest x-ray showed extensive bilateral infiltrates, and she was quickly intubated for acute hypoxic respiratory failure. A urine legionella antigen test was positive, and she was admitted to the intensive care unit with a diagnosis of severe legionella pneumonia. She improved over the next week with a course of levofloxacin. Once improved, the state health department visited her home and interviewed her husband and determined that she had not been cleaning her continuous positive pressure mask, tubing and humidifier appropriately. They concluded that the legionella likely came from her continuous positive airway pressure equipment. Cases of legionella pneumonia have frequently been reported through infected water supplies and even respiratory equipment. It is crucial that the mask and tubing used with these devices are cleaned appropriately to minimize the risk of infection.

Keywords: Respiratory medicine; critical care/emergency medicine; legionella; obstructive sleep apnea.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Chest x-ray of patient when she represented to the hospital emergency department. Significant for multifocal infiltrates with a differential of multifocal pneumonia, aspiration or alveolar edema.
See this image and copyright information in PMC

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