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Severe Legionella pneumophila pneumonia and non-invasive ventilation: presentation of two cases and brief review of the literature
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Abstract
Legionella pneumophila is an agent also well known to be frequently responsible for severe community acquired pneumonia. Recent studies regarding severe community-acquired pneumonia have shown that Legionella pneumophila is the second most common cause of admission to ICU, not far behind pneumococcal pneumonia. The mortality of severe Legionella pneumonia is high (30%). We report two cases of severe respiratory failure due to Legionella pneumophila type 1 treated with non-invasive ventilation in the Respiratory Intermediate Care Unit of a Department of Respiratory Medicine with good outcomes. Severe community-acquired pneumonia is the most common cause of ARDS, and it is the primary reason for Intensive Care Unit admission with invasive mechanical ventilation. Delay in ICU admission is probably associated with a poorer outcome. The use of non-invasive ventilation in severe community acquired pneumonia is controversial. However, after recent pandemics, the number of studies reporting good rates of success for NIV has increased. Both our patients were managed in a respiratory intermediate care unit, avoiding invasive ventilation and invasive monitoring, which lowered costs yet was equally effective in providing a good outcome when compared to intubation in the Intensive Care Unit.
Abstract
Legionella pneumophila is an agent also well known to be frequently responsible for severe community acquired pneumonia. Recent studies regarding severe community-acquired pneumonia have shown that Legionella pneumophila is the second most common cause of admission to ICU, not far behind pneumococcal pneumonia. The mortality of severe Legionella pneumonia is high (30%). We report two cases of severe respiratory failure due to Legionella pneumophila type 1 treated with non-invasive ventilation in the Respiratory Intermediate Care Unit of a Department of Respiratory Medicine with good outcomes. Severe community-acquired pneumonia is the most common cause of ARDS, and it is the primary reason for Intensive Care Unit admission with invasive mechanical ventilation. Delay in ICU admission is probably associated with a poorer outcome. The use of non-invasive ventilation in severe community acquired pneumonia is controversial. However, after recent pandemics, the number of studies reporting good rates of success for NIV has increased. Both our patients were managed in a respiratory intermediate care unit, avoiding invasive ventilation and invasive monitoring, which lowered costs yet was equally effective in providing a good outcome when compared to intubation in the Intensive Care Unit.
Keywords
severe community-acquired pneumonia, severe respiratory failure, Legionella pneumophila, non-invasive ventilation, non-invasive monitoring
About this articleTitle
Severe Legionella pneumophila pneumonia and non-invasive ventilation: presentation of two cases and brief review of the literature
Journal
Advances in Respiratory Medicine
Issue
Article type
Case report
Pages
399-403
Bibliographic record
Pneumonol Alergol Pol 2013;81(4):399-403.
Keywords
severe community-acquired pneumonia
severe respiratory failure
Legionella pneumophila
non-invasive ventilation
non-invasive monitoring
Authors
Antonello Nicolini
Gianluca Ferraioli
Renata Senarega