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Legionella pneumonia — SCE Respiratory MCQ

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HardRespiratory InfectionsLegionella pneumoniaSCE Respiratory

A 46-year-old hotel worker returns from a conference with pneumonia, diarrhoea and confusion. Sodium is 126 mmol/L, ALT is mildly elevated and CXR shows multilobar consolidation. Sputum Gram stain is unhelpful. What is the most appropriate investigation?

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Correct answer: E — Urinary Legionella antigen with respiratory PCR or culture

Pneumonia with diarrhoea, hyponatraemia and travel or hotel exposure should prompt Legionella testing with urinary antigen and respiratory sampling for PCR or culture. Aspergillus precipitins and pleural ADA investigate different syndromes. IGRA does not diagnose acute Legionella pneumonia.

Reference: NICE NG250; BTS CAP Guideline