Legionnaires' disease associated with macular rash: two cases

Area of Science:

• Infectious Diseases
• Neurology
• Dermatology

Background:

• Legionnaires' disease, a bacterial pneumonia caused by Legionella pneumophila, typically affects the respiratory system.
• Extrapulmonary manifestations are common, but skin lesions are rare, with uncertain pathogenesis.
• Cutaneous involvement can present as erythematous, maculopapular, or petechial lesions.

Observation:

• Two adult women with Legionella pneumonia presented with unusual diffuse macular rash.
• One patient experienced severe peripheral polyneuropathy and flaccid quadriplegia concurrently.
• These cases highlight uncommon extrapulmonary manifestations of Legionnaires' disease.

Findings:

• The study describes two rare cases of Legionnaires' disease complicated by widespread macular rash.
• Neurological complications, including severe polyneuropathy and quadriplegia, were observed in one patient.
• This suggests a potential link between Legionella infection and specific dermatological and neurological presentations.

Implications:

• These findings expand the known spectrum of extrapulmonary manifestations in Legionnaires' disease.
• Understanding the pathogenesis of these rare skin and neurological complications is crucial for diagnosis and treatment.
• Further research is needed to elucidate the mechanisms underlying these uncommon presentations.