A Case of Legionella Pneumonia Complicated by Pneumatoceles and Pneumothorax

We report a rare case of Legionella pneumonia complicated by pneumatocele and recurrent pneumothorax. A previously healthy man in his 70s was diagnosed with Legionella pneumonia and treated with levofloxacin, resulting in initial improvement. However, he developed progressive hypoxemia with diffuse ground-glass opacities and traction bronchiectasis, requiring corticosteroid therapy. A 5-cm pneumatocele subsequently appeared in the right lower lobe, followed by two episodes of right-sided pneumothorax. Surgical bullectomy was performed to control the recurrence. The pneumatocele resolved spontaneously by discharge. Pneumatoceles are typically associated with necrotizing infections but have not been previously reported following Legionella pneumonia. This case underscores a previously undocumented structural complication and highlights the importance of radiological monitoring and surgical readiness in selected patients with post-Legionella respiratory deterioration.