PMID- 32218409
OWN - NLM
STAT- MEDLINE
DCOM- 20200917
LR  - 20220413
IS  - 1426-9686 (Print)
IS  - 1426-9686 (Linking)
VI  - 48
IP  - 283
DP  - 2020 Feb 26
TI  - Asymptomatic cardiac and gallbladder involvement at initial presentation of 
      Legionnaires' disease.
PG  - 60-64
AB  - Extrapulmonary manifestations of Legionnaires' disease (LD) include, inter alia 
      cardiac, brain, abdominal, joints and skin involvement. A CASE REPORT: The 
      authors describe a case of a 41-year-old immunocompetent female admitted due to a 
      high fever, chills and fatigue. She negated cough and chest or abdominal pain. 
      Initial chest X-ray was normal. Among laboratory abnormalities were: elevation of 
      C-reactive protein, procalcitonin, transaminases and creatinine, hyponatremia, 
      low white blood cell and platelet count and a moderate proteinuria. ECG showed 
      subtle ST elevation. Echocardiography revealed normal left ventricular (LV) 
      contractility and near normal longitudinal strain, mild myocardial thickening, 
      and a small pericardial effusion; additionally, in subcostal view, gallbladder 
      wall thickening (GBWT) was found. Positive L. pneumophila urinary antigen test 
      confirmed LD diagnosis. Control Xray and CT showed development of pleural 
      effusion and bilateral pulmonary infiltrations. Clinical and radiologic 
      improvement of the disease was achieved with ciprofloxacin therapy started from 
      admission. ECG abnormalities persisted for only 5 days, GBWT resolved after 9 
      days, pericardial effusion disappeared after 10 days; normalization of LV 
      thickness and an increase in longitudinal strain was found within 2 weeks. 
      However, cardiac magnetic resonance (CMR) performed after a month revealed focal 
      midmyocardial and linear subepicardial late gadolinium enhancement (LGE). 
      CONCLUSIONS: The authors underline the fact that being aware of extrapulmonary 
      LD, also silent, may allow to diagnose the disease, especially when pulmonary 
      involvement is initially absent.
CI  - (c) 2020 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 - Ganowicz-Kaatz, Teresa
AU  - Ganowicz-Kaatz T
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 - Pyda, Malgorzata
AU  - Pyda M
AD  - Poznan University of Medical Sciences, Poland: Cardiac Magnetic Resonance Unit, 
      1st 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  - Adult
MH  - Contrast Media
MH  - Female
MH  - Gadolinium
MH  - Gallbladder
MH  - Humans
MH  - *Legionella pneumophila
MH  - *Legionnaires' Disease
OTO - NOTNLM
OT  - Legionella pneumophila
OT  - Legionnaires' disease
OT  - cardiac magnetic resonance
OT  - extrapulmonary manifestation
OT  - late gadolinium enhancement
OT  - longitudinal strain
OT  - pericardial effusion
OT  - pleural effusion
OT  - transient gallbladder wall thickening
EDAT- 2020/03/29 06:00
MHDA- 2020/09/18 06:00
CRDT- 2020/03/29 06:00
PHST- 2020/03/29 06:00 [entrez]
PHST- 2020/03/29 06:00 [pubmed]
PHST- 2020/09/18 06:00 [medline]
AID - PML283-060 [pii]
PST - ppublish
SO  - Pol Merkur Lekarski. 2020 Feb 26;48(283):60-64.