title: A rare presentation of Legionnaires' disease.
abstract: We present an interesting case of Legionnaires' disease masquerading as acute pyelonephritis, with complete absence of respiratory symptoms on admission. A 45-year-old man was diagnosed with Legionnaires' disease 2 days after presenting to hospital with dysuria and right loin pain. He became critically unwell during the hospital admission, with headache, uncontrolled fever, breathlessness, decreasing oxygen saturations and increasing oxygen requirements. A CT pulmonary angiography demonstrated right upper lobar consolidation and Legionella urinary antigen was positive. He was treated with ciprofloxacin and rifampicin and made a full recovery.
authors.affiliation: Department of Care of the Elderly, Northern General Hospital, Sheffield, Yorkshire, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Delicata
authors.affiliation: Department of Adult Medicine, Scunthorpe General Hospital, Scunthorpe, North Lincolnshire, UK.
authors.forename: Amit
authors.initials: A
authors.lastname: Banerjee
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000652:urine; D002939:Ciprofloxacin / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000175:diagnosis; D003937:Diagnosis, Differential; D053159:Dysuria / Q000382:microbiology; D021501:Flank Pain / Q000382:microbiology; D006801:Humans; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis; D011704:Pyelonephritis / Q000175:diagnosis*; D012293:Rifampin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D002939:Ciprofloxacin; D012293:Rifampin