Legionella pneumonia in neonates: a literature review

It has recently been recognized that neonates may develop pneumonia as a result of Legionella pneumophila. The objective of this study is to characterize the epidemiology, risk factors, diagnosis, clinical features, and outcome of neonatal legionellosis. Review of the literature revealed nine cases of neonatal Legionella infection. Five neonates were term infants and four were preterm. Eight had potential risk factors such as prematurity, congenital heart disease, bronchopulmonary dysplasia, or corticosteroid therapy. Diagnosis was proven by culture in all cases. The main presentation was acute respiratory distress requiring mechanical ventilation. In six infants, the infection had a fatal outcome, including five who were not treated with erythromycin. All the cases were nosocomial, and environmental Legionella was documented in five cases. As has been noted in adults and children with Legionella, early recognition and institution of appropriate therapy are the most important determinants of the prognosis.