title: Legionella Infection in Pregnancy: The Forgotten Pathogen in Septic Shock.
abstract: BACKGROUND
  Of eight cases of Legionella infection in pregnancy reported over 35 years, there was one case of maternal septic shock with poor outcome, one recovery with good outcome, and six with poor outcome.
  
  
  METHODS
  A 30-year-old woman, gravida 2 para 1, at 28 weeks of gestation presented with a high fever, cough, nausea, and vomiting. She deteriorated despite treatment for presumed urosepsis, was transferred to the intensive care unit, and remained intubated for 10 days receiving cardiovascular support, antivirals, antifungals, and multiple wide-spectrum antibiotics. Legionella infection antigen testing was performed on hospital day 1 and returned as positive. Azithromycin, started before the testing results became available, was continued for 14 days. The patient recovered, and the pregnancy progressed uneventfully to term.
  
  
  CONCLUSIONS
  Legionella infection should be considered with maternal deterioration despite broad-spectrum antibiotic coverage. A favorable outcome is possible with early diagnosis and treatment.
authors.affiliation: College of Medicine and the Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Jack
authors.initials: J
authors.lastname: Xu
authors.forename: Imelda N
authors.initials: IN
authors.lastname: Odibo
authors.forename: Donna G
authors.initials: DG
authors.lastname: Eastham
authors.forename: Nafisa K
authors.initials: NK
authors.lastname: Dajani
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007876:Legionellosis / Q000150:complications* / Q000628:therapy; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology* / Q000628:therapy; D012772:Shock, Septic / Q000382:microbiology* / Q000628:therapy