Journal Information
Vol. 31. Issue 5.
Pages 249-251 (May 1995)
Share
Share
Download PDF
More article options
Vol. 31. Issue 5.
Pages 249-251 (May 1995)
Full text access
Pleuropericarditis como manifestación única de infección por Legionella pneumophila
Pleuropericarditis as the single sign of infection by Legionella pneumophila
Visits
6550
D. Torrús Tendero1, A. Díez Ruiz, J.M. Bermúdez García, J. Rico Irles
Servicios de Medicina Interna. Hospital Universitario de Granada
J. Gutiérrez Fernández*
* Servicios de Microbiología. Hospital Universitario de Granada
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics

La presencia de derrame pleural por Legionella no es infrecuente, sin embargo, suele ser de escasa relevancia. La afectación del pericardio ha sido descrita raramente. Presentamos un caso de pleuropericarditis como manifestación única de infección por Legionella pneumophila en un varón de 66 años, sin antecedentes patológicos que ingresó con dolor torácico de características pleuríticas, febrícula, tos seca y disnea. El diagnóstico se realizó retrospectivamente mediante inmunofluorescencia indirecta, por no sospechar inicialmente la etiología. Tras instaurar tratamiento con eritromicina a dosis elevadas durante 3 semanas, la evolución clínica del paciente fue favorable, encontrándose asintomático hasta la fecha. Concluimos que, en aquellos casos de pleuritis o pericarditis de etiología incierta, se ha de investigar sistemáticamente la infección por Legionella pneumophila.

Palabras clave:
Legionella
Pleuropericarditis
Derrame pleural
Derrame pericárdico

Pleural effusion caused by Legionella is seen fairly frequently but is hardly ever of great clinical significance. Pericardial involvement has been described only rarely. We present a case of pleuropericarditis as the only sign of infection by Legionella pneumophila in a 66-years-old man with no prior history of disease. The patient carne to the hospital with chest pain suggestive of pleurisy, low-grade fever, dry cough and dyspnea. The etiology was not suspected and the diagnosis was made retrospectively based on indirect immunofluorescence. After 3 weeks of treatment with high dosis of erythromycin the patient recovered and remains asymptomatic to date. We conciude that infection by Legionella pneumophila should be suspected in patients with pleurisy or pericarditis of unknown cause.

Key words:
Legionella
Pleuropericarditis
Pleural effusion
Pericardic effusion
Full text is only aviable in PDF
Bibliografía
[1.]
M.N. Swartz.
Clinical aspects of Legionnaires’ disease.
Ann Intern Med, 90 (1979), pp. 492-495
[2.]
E. Bouza, M. Rodríguez.
Enfermedad de los legionarios.
Revisión. Med Clin (Barc), 77 (1981), pp. 298-310
[3.]
P.H. Edelstein, R.D. Meyer.
Legionnaires’ disease. A review.
Chest, 85 (1984), pp. 114-120
[4.]
R. Monforte.
Legionelosis.
Med Clin (Barc), 93 (1989), pp. 535-537
[5.]
D.W. Fraser, T.R. Tsai, W. Orenstein, W.E. Parkin, J. Beecham, R.G. Sharrer, et al.
Legionnaires’ disease. Description of an epidemic of pneumonía.
N Engl J Med, 297 (1977), pp. 1.189-1.197
[6.]
S.M. Finegold.
Legionnaires’ disease-still with us.
N Engl J Med, 318 (1988), pp. 571-573
[7.]
L.F. Harris.
Legionnaires's disease associated with massive pericardial effusion [carta].
Arch Intern Med, 141 (1981), pp. 1.385
[8.]
C. Spanò, M. Menozzi.
Legionnaires’ disease in Palermo and possible involvement of Legionella pneumophila in cases of pericardial effusion.
Infection, 10 (1982), pp. 103-104
[9.]
L. Friedland, D.R. Snydman, A.S. Weingarden, T.R. Hedges, R. Brown, M. Busky.
Ocular and pericardial involvement in Legionnaires’ disease.
Am J Med, 77 (1984), pp. 1.105-1.107
[10.]
B.W. Landes, G.W. Pogson, G.D. Beauchamp, R.K. Skillman, J.M. Brewer.
Pericarditis in a patient with Legionnaires’ disease.
Arch Intern Med, 142 (1982), pp. 1.234-1.235
[11.]
C.H. Domingo, J. Roig, J. Seres.
Pericardial effusion as a clinical sign of Legionnaire's disease.
Internt J Card, 23 (1989), pp. 407-409
[12.]
R. Mayock, B. Skale, R.B. Kohler.
Legionella pneumophila pericarditis proved by culture of pericardial fluid.
Am J Med, 75 (1983), pp. 534-536
[13.]
P.C.H. Lück, J.H. Helbig, E. Wunderlich, H. Foelske, M. Selbitschka, D. Wenzel, et al.
Isolation of Legionella pneumophila serogroup 3, from pericardial fluid in a case of pericarditis.
Infection, 17 (1989), pp. 388-390
[14.]
D.P. Nelson, E.R. Rensimer, C.M. Burke, T.A. Raffin.
Cardiac legionellosis.
Chest, 86 (1984), pp. 807-808
[15.]
D. Gross, H. Willens, S.M. Zeldis.
Myocarditis in Legionnaires’ disease.
Chest, 79 (1981), pp. 232-234
[16.]
H.J. White, W.W. Felton, N.S. Chao.
Extrapulmonary histopathologic manifestations of Legionnaires’ disease.
Arch Pathol Lab Med, 104 (1980), pp. 287-289
[17.]
L.S. Tompkins, B.J. Roessler, S.C. Redd, L.E. Markowitz, M.L. Cohén.
Legionella prosthetic-valve endocarditis.
N Engl J Med, 318 (1988), pp. 530-535
[18.]
B.D. Kirby, H. Peck, R.D. Meyer.
Radiographic features of Legionnaires’ disease.
Chest, 76 (1979), pp. 562-565
[19.]
R.D. Meyer, P.H. Edelstein, B.D. Kirby, M.H. Louie, M.E. Mulligan, A.A. Morgenstein, et al.
Legionnaires’ disease: unusual clinical and laboratory features.
Ann Intern Med, 93 (1980), pp. 240-243
[20.]
E. Ribera, A. Ferrer, R. Gelabert, M. Xercavins, J.M. Martínez-Vázquez.
Empiema pleural por Legionella pneumophila.
Med Clin (Barc), 92 (1989), pp. 605-607
[21.]
J. Juega, J.D. Pedreira, F. De la Iglesia, V. Ramos.
Derrame plural masivo por Legionella pneumophila.
An Med Intern (Madrid), 8 (1991), pp. 571-572
[22.]
K.A. Randolph, J.F. Beekman.
Legionnaires’ disease presenting with empyema.
Chest, 75 (1979), pp. 404-406
[23.]
A.P. Freedman, E. Coodley, R.F. Johnston, L. Goodman, S.M. Katz.
Loculated pleural effusion caused by Legionella pneumophila.
Thorax, 37 (1982), pp. 79-80
Copyright © 1995. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?