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Severe Pleural Effusion Due to Legionella pneumophila Respiratory Infection

João D. Bettencourt, MD; Angelo Barroso, MD; H. Carmona da Mota, MD
Arch Pediatr Adolesc Med. 1994;148(11):1218-1219. doi:10.1001/archpedi.1994.02170110104022.
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Infection with Legionella pneumophila (LP) is a rare cause of pneumonia in previously healthy children.1,2 As observed by Granados et al3 and Yu et al,4 pneumonia due to infection with LP in adults presents like a typical bacterial pneumonia. The initial clinical, radiological, and analytic differences are of little help in making a diagnosis.5,6 Empiric therapy may be necessary until the diagnosis is confirmed.7

Although not uncommon in cases of pneumonia caused by infection with LP (36%),8,9 the pleural effusion associated with it is usually minimal and much less important than that found in pneumococcal pneumonia.10

Herein we describe an immunologically normal 4-year-old child with a severe sporadic case of LP respiratory infection that was complicated with huge pleural effusion that consolidated and with diaphragmatic paralysis that led to surgical decortication.

Patient Report. A previously healthy 4-year-old boy presented with fever, vomiting, and

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