PMID- 31385942
OWN - NLM
STAT- MEDLINE
DCOM- 20191016
LR  - 20220410
IS  - 1426-9686 (Print)
IS  - 1426-9686 (Linking)
VI  - 47
IP  - 277
DP  - 2019 Jul 29
TI  - Severe transient left ventricular dysfunction in a patient with Legionella 
      pneumophila pneumonia.
PG  - 19-24
AB  - Legionella pneumophila infection (legionellosis) usually presents as a 
      multisystemic disease, predominantly affecting the lungs (Legionnaires' disease - 
      LD). Immunodeficiency, chemotherapy or chronic steroids use increase the risk of 
      developing LD. Extrapulmonary manifestations of LD include cardiac complications: 
      myocarditis, pericarditis or endocarditis. A CASE REPORT: The authors describe a 
      case of a 51-year-old female with a history of cryoglobulinemic vasculitis, 
      Sjogren syndrome and chronic lymphocytic leukemia who was admitted due to a high 
      fever, fatigue, tachycardia, dyspnea and cough. Chest X-ray and CT showed 
      bilateral pulmonary infiltrations and pleural effusion. LD was diagnosed on 
      positive L. pneumophila urinary antigen test. Echocardiography revealed severe 
      left ventricular (LV) dysfunction with substantially decreased ejection fraction 
      and global longitudinal strain (GLS), with a pattern resembling reverse takotsubo 
      syndrome (rTTS). The coronary arteries in non-invasive coronary angiography were 
      normal. During therapy with levofloxacin and intravenous immunoglobulins as well 
      as with carvedilol, ramipril and diuretics, gradual clinical improvement with 
      complete normalization of LV function was observed within 5 weeks. Cardiac 
      magnetic resonance (CMR) performed on day 35 revealed only small intramural foci 
      of late gadolinium enhancement (LGE) with localization not corresponding to the 
      most decreased regional longitudinal strain in the initial echocardiographic 
      examination. The authors suggest that the mechanism of transient LV dysfunction 
      in the case presented may have been of complex nature, including LD myocarditis 
      and stress-induced cardiomyopathy (with the prevalence of the latter) which has 
      not so far been reported in the literature.
CI  - (c) 2019 MEDPRESS.
FAU - Elikowski, Waldemar
AU  - Elikowski W
AD  - Jozef Strus Hospital, Poznan, Poland: Department of Internal Medicine.
FAU - Malek-Elikowska, Malgorzata
AU  - Malek-Elikowska M
AD  - Poznan University of Medical Sciences, Poland: 2nd Department of Cardiology.
FAU - Greberska, Weronika
AU  - Greberska W
AD  - Jozef Strus Hospital, Poznan, Poland: Department of Cardiology.
FAU - Fertala, Natalia
AU  - Fertala N
AD  - Jozef Strus Hospital, Poznan, Poland: Department of Internal Medicine.
FAU - Zawodna, Magdalena
AU  - Zawodna M
AD  - Jozef Strus Hospital, Poznan, Poland: Department of Internal Medicine.
FAU - Marchlewska, Joanna
AU  - Marchlewska J
AD  - Jozef Strus Hospital, Poznan, Poland: Department of Internal Medicine.
FAU - Dudziak, Joanna
AU  - Dudziak J
AD  - Jozef Strus Hospital, Poznan, Poland: Department of Cardiology.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - Poland
TA  - Pol Merkur Lekarski
JT  - Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
JID - 9705469
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Contrast Media
MH  - Female
MH  - Gadolinium
MH  - Humans
MH  - *Legionella
MH  - *Legionella pneumophila
MH  - *Legionnaires' Disease/complications
MH  - Middle Aged
MH  - *Pneumonia/complications
MH  - *Ventricular Dysfunction, Left/etiology
OTO - NOTNLM
OT  - Legionella pneumophila
OT  - Legionnaires' disease
OT  - longitudinal strain
OT  - myocarditis
OT  - reversible heart failure
OT  - stress+induced cardiomyopathy
OT  - takotsubo syndrome
OT  - transient left ventricular dysfunction
EDAT- 2019/08/07 06:00
MHDA- 2019/10/17 06:00
CRDT- 2019/08/07 06:00
PHST- 2019/08/07 06:00 [entrez]
PHST- 2019/08/07 06:00 [pubmed]
PHST- 2019/10/17 06:00 [medline]
AID - PML277-019 [pii]
PST - ppublish
SO  - Pol Merkur Lekarski. 2019 Jul 29;47(277):19-24.