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Lung examination reveals rales and signs of consolidation late in the disease
course.Respiratory symptoms may not be present initially but develop as the
disease progresses. Almost all patients develop a cough, which is initially
dry and nonproductive, but may become productive, with purulent sputum
and, (in rare cases) hemoptysis. Patients may experience chest pain.
Extrapulmonary legionellosis is rare; the most common site of
extrapulmonaryinfectioninadultsistheheart.Manifestationsofextrapulmonary
legionellosis may include the following: cellulitis,peritonitis, pancreatitis,
synusites, pyelonephritis, lymphadenopathy, myocarditis, pericarditis.
Neurologic and GI symptoms are usually prominent. Neurologic complaints
may include the following: Headache,Lethargy,Confusion,Cerebellar
ataxia,Agitation,Stupor. Common GI symptoms include diarrhea (watery and
nonbloody), nausea, vomiting, and abdominal pain.
Radiologic Manifestations
The chest radiographs can shows lobar shadow ,unilateral involvement
(the most common lung shadows were poorly marginated round opacities),
diffuse patchy and peripheral opacities .Pleural effusions can be present , but
could be explained by underlying congestive heart failure or renal failure.
Although the findings are not specific, the radiologist should consider this
diagnosis in a patient with compatible clinical history, a pneumonia of
obscure etiology, and these radiographic manifestations. (Fig 1)
