title: Rash, disseminated intravascular coagulation and legionella: Episode 10 and a rewind into the past.
abstract: Legionella pneumophila is the most common cause of legionellosis and is one of the organisms causing atypical pneumonia. We report the presentation of disseminated intravascular coagulation (DIC) and skin rash in a single case of severe Legionella pneumonia. The unique clinical presentation of a diffuse rash diagnosed as purpura fulminans and the unpredictable variations encountered during the diagnostic work-up of the case make this write-up crucial. This article synthesizes all reported cases of L. pneumonia associated with cutaneous manifestations as well as cases presenting with DIC. Furthermore, this manuscript illustrates the correlation between cutaneous and coagulopathic manifestations, and morbidity and mortality from L. pneumonia.
authors.affiliation: Department of Internal Medicine, University of Pittsburgh Medical Center McKeesport, PA, USA.
authors.forename: Prashanth M
authors.initials: PM
authors.lastname: Thalanayar
authors.affiliation: Department of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Holguin
keywords: DIC; Legionella; Pneumophila; Skin rash; Urine antigen