Legionnaires' disease arising with hirsutism: case report of an extremely confusing event.


Journal

BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551

Informations de publication

Date de publication:
06 Jun 2021
Historique:
received: 27 05 2020
accepted: 27 05 2021
entrez: 7 6 2021
pubmed: 8 6 2021
medline: 11 6 2021
Statut: epublish

Résumé

Legionella bacteria is a common cause of pneumonia, but the infection may affect several organs in the most serious cases. A systemic involvement ab initio could be non-specific, leading to a diagnostic misinterpretation. A 33-year-old woman had been complaining of mental confusion, restlessness, aggressiveness, and, subsequently, hirsutism. After 3 weeks, the patient developed pneumonia and died during the hospitalization. The autopsy examination revealed a multi-organ necrotizing exudative disease involving the lung, the heart and the brain. The microbiological tests of tracheal aspirate were positive for Legionella pneumophila serotype 1. The Legionella infection may show a proteiform clinical course and an extra-pulmonary manifestation may be the first sign of the disease. Herein, we report a case of Legionella infection in a young female, presenting with non-specific neurological symptoms and hirsutism at onset, misdiagnosed as a metabolic disease.

Sections du résumé

BACKGROUND BACKGROUND
Legionella bacteria is a common cause of pneumonia, but the infection may affect several organs in the most serious cases. A systemic involvement ab initio could be non-specific, leading to a diagnostic misinterpretation.
CASE PRESENTATION METHODS
A 33-year-old woman had been complaining of mental confusion, restlessness, aggressiveness, and, subsequently, hirsutism. After 3 weeks, the patient developed pneumonia and died during the hospitalization. The autopsy examination revealed a multi-organ necrotizing exudative disease involving the lung, the heart and the brain. The microbiological tests of tracheal aspirate were positive for Legionella pneumophila serotype 1.
CONCLUSION CONCLUSIONS
The Legionella infection may show a proteiform clinical course and an extra-pulmonary manifestation may be the first sign of the disease. Herein, we report a case of Legionella infection in a young female, presenting with non-specific neurological symptoms and hirsutism at onset, misdiagnosed as a metabolic disease.

Identifiants

pubmed: 34092232
doi: 10.1186/s12879-021-06247-9
pii: 10.1186/s12879-021-06247-9
pmc: PMC8183093
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

532

Références

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Am J Med. 2015 Jul;128(7):e21-2
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Am J Med. 2014 Oct;127(10):1010.e11-9
pubmed: 24813862

Auteurs

Gabriella Serio (G)

Department of Emergency and Organ Transplantation, Pathology Division, University of Bari, Bari, Italy.

Francesco Fortarezza (F)

Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Pathology Unit, University of Padova, Gabelli St. 61, 35121, Padova, Italy. francescofortarezza.md@gmail.com.

Federica Pezzuto (F)

Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Pathology Unit, University of Padova, Gabelli St. 61, 35121, Padova, Italy.

Luigi Santacroce (L)

Department Ionian (DJSGEM), Microbiology and Virology Laboratory, University of Bari, Bari, Italy.

Pietro Nazzaro (P)

Department of Medical Basic Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy.

Emilio Bellitti (E)

Department of Emergency and Organ Transplantation, Pathology Division, University of Bari, Bari, Italy.

Domenica Cavone (D)

Department of Interdisciplinary Medicine, Occupational Health Division, University of Bari, Bari, Italy.

Andrea Marzullo (A)

Department of Emergency and Organ Transplantation, Pathology Division, University of Bari, Bari, Italy.

Luigi Vimercati (L)

Department of Interdisciplinary Medicine, Occupational Health Division, University of Bari, Bari, Italy.

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