Cavitary Legionella Pneumonia in AIDS: When Intracellular Immunity Failure Leads to Rapid Intrapulmonary Cavitation

Introduction. Legionella is a frequent cause of bacterial pneumonia in patients with AIDS. While multiple organisms have been associated with cavitary pneumonia in this population, Legionella has not. Clinical Case. A middle-aged woman with HIV-AIDS and severely depressed CD-4 count presented with o...

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Main Authors: Richard Jesse Durrance, Alice Kyungsun Min, Marilyn Fabbri, Terrence McGarry
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Pulmonology
Online Access:http://dx.doi.org/10.1155/2021/6754094
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author Richard Jesse Durrance
Alice Kyungsun Min
Marilyn Fabbri
Terrence McGarry
author_facet Richard Jesse Durrance
Alice Kyungsun Min
Marilyn Fabbri
Terrence McGarry
author_sort Richard Jesse Durrance
collection DOAJ
description Introduction. Legionella is a frequent cause of bacterial pneumonia in patients with AIDS. While multiple organisms have been associated with cavitary pneumonia in this population, Legionella has not. Clinical Case. A middle-aged woman with HIV-AIDS and severely depressed CD-4 count presented with one month of progressively worsening productive cough and dyspnea. Serial imaging showed focal consolidations which multiplied and cavitated over the subsequent days. Legionella urine antigen was positive, and appropriate treatment was continued for 3 weeks total. The patient recovered quickly, and follow-up imaging 8 weeks later showed near-resolution of all lesions. Discussion. Cavitary pneumonia secondary to Legionella has been seldom described, traditionally in the context of immunosuppressive therapy. Patients with AIDS and severely depressed CD4 counts have significantly compromised cell-mediated immunity. This case highlights the importance of consideration for legionellosis in rapidly progressing cavitary pneumonia, especially in patients with severely compromised cell-mediated immunity, including those with HIV-AIDS.
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spelling doaj-art-afaa60ebd06145d894f01efe19d06a212025-08-20T03:39:04ZengWileyCase Reports in Pulmonology2090-68542021-01-01202110.1155/2021/6754094Cavitary Legionella Pneumonia in AIDS: When Intracellular Immunity Failure Leads to Rapid Intrapulmonary CavitationRichard Jesse Durrance0Alice Kyungsun Min1Marilyn Fabbri2Terrence McGarry3Division of Pulmonary and Critical CareDivision of Infectious DiseaseDivision of Infectious DiseaseDivision of Pulmonary and Critical CareIntroduction. Legionella is a frequent cause of bacterial pneumonia in patients with AIDS. While multiple organisms have been associated with cavitary pneumonia in this population, Legionella has not. Clinical Case. A middle-aged woman with HIV-AIDS and severely depressed CD-4 count presented with one month of progressively worsening productive cough and dyspnea. Serial imaging showed focal consolidations which multiplied and cavitated over the subsequent days. Legionella urine antigen was positive, and appropriate treatment was continued for 3 weeks total. The patient recovered quickly, and follow-up imaging 8 weeks later showed near-resolution of all lesions. Discussion. Cavitary pneumonia secondary to Legionella has been seldom described, traditionally in the context of immunosuppressive therapy. Patients with AIDS and severely depressed CD4 counts have significantly compromised cell-mediated immunity. This case highlights the importance of consideration for legionellosis in rapidly progressing cavitary pneumonia, especially in patients with severely compromised cell-mediated immunity, including those with HIV-AIDS.http://dx.doi.org/10.1155/2021/6754094
spellingShingle Richard Jesse Durrance
Alice Kyungsun Min
Marilyn Fabbri
Terrence McGarry
Cavitary Legionella Pneumonia in AIDS: When Intracellular Immunity Failure Leads to Rapid Intrapulmonary Cavitation
Case Reports in Pulmonology
title Cavitary Legionella Pneumonia in AIDS: When Intracellular Immunity Failure Leads to Rapid Intrapulmonary Cavitation
title_full Cavitary Legionella Pneumonia in AIDS: When Intracellular Immunity Failure Leads to Rapid Intrapulmonary Cavitation
title_fullStr Cavitary Legionella Pneumonia in AIDS: When Intracellular Immunity Failure Leads to Rapid Intrapulmonary Cavitation
title_full_unstemmed Cavitary Legionella Pneumonia in AIDS: When Intracellular Immunity Failure Leads to Rapid Intrapulmonary Cavitation
title_short Cavitary Legionella Pneumonia in AIDS: When Intracellular Immunity Failure Leads to Rapid Intrapulmonary Cavitation
title_sort cavitary legionella pneumonia in aids when intracellular immunity failure leads to rapid intrapulmonary cavitation
url http://dx.doi.org/10.1155/2021/6754094
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AT terrencemcgarry cavitarylegionellapneumoniainaidswhenintracellularimmunityfailureleadstorapidintrapulmonarycavitation