Transient left ventricular dysfunction associated with severe Legionella infection

Area of Science:

• Infectious Diseases
• Cardiology
• Critical Care Medicine

Background:

• Legionella infection typically presents as pneumonia but can lead to systemic complications.
• Severe systemic manifestations of Legionella are uncommon but can be life-threatening.

Purpose of the Study:

• To report a rare case of Legionella infection with multi-organ involvement, including severe left ventricular dysfunction.
• To highlight the potential cardiac impact of Legionella and the effectiveness of intensive care management.

Main Methods:

• Case report of a patient with Legionella pneumonia, rhabdomyolysis, renal failure, and septic shock.
• Management included percutaneous cardiopulmonary support, intraaortic balloon pumping, and continuous hemodialysis with endotoxin adsorption.
• Endomyocardial biopsy was performed to assess cardiac involvement.

Main Results:

• The patient presented with pneumonia, rhabdomyolysis, renal failure, and severe left ventricular dysfunction, progressing to refractory septic shock.
• Endomyocardial biopsy showed no inflammatory infiltrates.
• Intensive care interventions led to spontaneous improvement in left ventricular function and reduced inflammatory cytokine levels.

Conclusions:

• Legionella infection should be considered in patients with sepsis presenting with unexplained left ventricular dysfunction.
• Aggressive intensive care, including advanced hemodynamic support and inflammatory modulation, can be crucial for managing severe Legionella-associated cardiac complications.