Legionella pneumophila as a cause of cavitary lung disease in systemic lupus erythematous

Lupus. 2021 May;30(6):1010-1012. doi: 10.1177/0961203321990102. Epub 2021 Jan 26.

Abstract

Legionnaire's disease (LD) is most commonly caused by Legionella pneumophila (L. pneumophila). In immunocompromised patients LD can cause necrosis of the lung parenchyma with abscess formation and cavitation. Systemic lupus erythematosus (SLE) is an autoimmune disorder with features of both primary and secondary immunodeficiency. SLE patients often develop pulmonary abnormalities, but rarely develop lung cavitations. We report a case of cavitary pneumonia caused by L. pneumophila in a 64-year-old female patient with SLE. We also highlight reasons why SLE patients are more prone to L. pneumophila infections. The importance of using correct diagnostic methods for recognizing and treating such infections is also discussed, as mistreatment of cavitary lesions in SLE patients with steroid therapy can have fatal outcomes as the infectious process can significantly worsen.

Keywords: Legionella pneumonia; Legionella pneumophila; Lung cavitation; lung abscess; lupus nephritis; systemic lupus erythematosus.

Publication types

  • Case Reports

MeSH terms

  • Cross Infection / microbiology
  • Diagnosis, Differential
  • Female
  • Humans
  • Legionella pneumophila / isolation & purification*
  • Legionnaires' Disease / diagnosis
  • Legionnaires' Disease / microbiology*
  • Lupus Erythematosus, Systemic / complications*
  • Middle Aged
  • Pneumonia / diagnosis
  • Pneumonia / microbiology*
  • Pneumonia / pathology