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Legionella pneumonia — SCE Respiratory MCQ

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ModerateRespiratory InfectionsLegionella pneumoniaSCE Respiratory

A 44-year-old hotel maintenance worker develops fever, diarrhoea, dry cough and confusion after repairing air-conditioning units. Sodium is 126 mmol/L and chest radiograph shows bilateral patchy consolidation. What is the most appropriate investigation?

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Correct answer: C — Legionella urinary antigen and respiratory PCR/culture

Pneumonia with diarrhoea, confusion, hyponatraemia and cooling-system exposure suggests Legionella, so urinary antigen plus respiratory PCR/culture is appropriate. Serum ACE and FeNO investigate sarcoidosis or asthma rather than atypical pneumonia. Overnight oximetry does not identify the causative pathogen.

Reference: NICE NG250 Pneumonia in Adults; BTS CAP Guideline