Case history
Case history #1
A 55-year-old woman with a history of tobacco use (40 pack-years) presents with a 3-day history of fever, dyspnea, and a cough productive of thick yellow sputum. She also reports a headache with some nausea and vomiting for the last 24 hours. She travels frequently, and most recently attended a conference in Boston, MA, for 5 days, where she stayed in the large hotel where the conference was being held.
Case history #2
A 42-year-old man presents with fever, myalgia, and headache for 24 hours. He denies any shortness of breath or cough. He has a history of hypertension and type 2 diabetes mellitus and works in construction.
Other presentations
Legionnaires' disease may also present with a fever with pulse-temperature dissociation, nonproductive cough, few pulmonary symptoms, bradycardia, diarrhea, abdominal pain, hyponatremia, and elevated aspartate aminotransferase and alanine aminotransferase. It was once thought that bradycardia, hyponatremia, diarrhea, and abdominal pain were unique to legionellosis, but a study in 2001 found that a scoring system based on these symptoms was neither specific nor sensitive.[2]
Rarely, in immunocompromised patients, infection may spread from the lung to other sites in the body.[3]
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