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Legionella pneumonia — SCE Respiratory MCQ

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ModerateRespiratory infectionsLegionella pneumoniaSCE Respiratory

A 52-year-old man returns from a hotel conference with fever, dry cough, diarrhoea and confusion. Sodium is 126 mmol/L, ALT is mildly raised and chest radiograph shows bilateral patchy consolidation. Several other delegates have similar symptoms. Urinary pneumococcal antigen is negative. What is the most likely diagnosis?

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Correct answer: B — Legionella pneumophila pneumonia

Hyponatraemia, diarrhoea, transaminitis and a hotel outbreak point towards Legionella pneumonia. Mycoplasma can cause atypical pneumonia but is less associated with this exposure cluster and biochemical pattern. Treatment should include an agent active against intracellular atypical organisms.

Reference: BTS CAP Guideline; UKHSA Legionnaires’ disease guidance