title: Acute Psychosis as Major Clinical Presentation of Legionnaires' Disease.
abstract: We report a case of a 61-year-old woman who presented with acute psychosis as a major manifestation of Legionnaires' disease in the absence of other neuropsychiatric symptoms. Clinical history revealed dry cough and nausea. Observation showed fever and auscultation crackles in the lower lobe of the right lung. Laboratory testing demonstrated elevated C-reactive protein and lung chest radiograph showed patchy peribronchial and right lower lobe consolidation. Soon after admission, she started producing purulent sputum. Epidemiological data suggested Legionella pneumophila as possible cause of the clinical picture that was confirmed by urinary antigen detection and polymerase chain reaction of the sputum. She was treated with levofloxacin 750 mg/day for 10 days with complete remission of pulmonary and psychiatric symptoms. She has not had further psychotic symptoms.
authors.affiliation: Department of Psychiatry, Hospital Vila Franca de Xira, Estrada Nacional N1, 2600-009 Vila Franca de Xira, Portugal; Faculty of Medicine, University of Lisbon, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal.
authors.forename: Ricardo
authors.identifier: 0000-0002-2939-9436
authors.initials: R
authors.lastname: Coentre
authors.affiliation: Department of Psychiatry, Hospital Vila Franca de Xira, Estrada Nacional N1, 2600-009 Vila Franca de Xira, Portugal.
authors.forename: Amílcar
authors.initials: A
authors.lastname: Silva-Dos-Santos
authors.affiliation: Department of Psychiatry, Hospital Vila Franca de Xira, Estrada Nacional N1, 2600-009 Vila Franca de Xira, Portugal; CEDOC, Chronic Diseases Research Centre, Nova Medical School, Faculdade de Ciências Médicas, New University of Lisbon, Campo Mártires da Pátria, 1169-056 Lisboa, Portugal.
authors.forename: Miguel Cotrim
authors.initials: MC
authors.lastname: Talina