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