Legionnaires' Disease with Facial Nerve Palsy

Legionnaires' disease is primarily a pneumonic process caused by Legionella pneumophilia, a gram-negative aerobic bacillus but also has multiple system involvement. The most common manifestation is encephalopathy suggesting a generalized brain dysfunction but focal neurological manifestations...

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Main Authors: Shailesh R. Basani, Salwa Mohamed Ahmed, Eyassu Habte-Gabr
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2011/916859
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author Shailesh R. Basani
Salwa Mohamed Ahmed
Eyassu Habte-Gabr
author_facet Shailesh R. Basani
Salwa Mohamed Ahmed
Eyassu Habte-Gabr
author_sort Shailesh R. Basani
collection DOAJ
description Legionnaires' disease is primarily a pneumonic process caused by Legionella pneumophilia, a gram-negative aerobic bacillus but also has multiple system involvement. The most common manifestation is encephalopathy suggesting a generalized brain dysfunction but focal neurological manifestations have been reported. We report a patient with Legionella pneumonia associated with cerebellar dysfunction and unilateral facial nerve weakness. 51-year-old previously healthy male presented with shortness of breath, cough, slurred speech, and unsteadiness on feet associated with malaise, fevers and myalgias. Patient's family reported facial asymmetry for 2 days. Patient had no significant medical history and was not on any medication. He denied smoking, alcohol or illicit drug use. Chest X-ray showed bilateral lower lobe infiltrates. Urinary antigen assay for Legionella pneumophilia serogroup 1 was positive. Patient was started on intravenous moxifloxacin. On day 5 the patient was discharged home and continued oral moxifloxacin for two weeks. After the two weeks, his respiratory symptoms, gait ataxia and dysarthria resolved. We report the first case of Legionnaires' disease with cerebellar dysfunction and seventh nerve palsy. Legionnaires' disease should be considered in patients with any neurological symptoms in the setting of pneumonia. Failure to recognize and treat the infection may lead to poor outcomes.
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spelling doaj-art-8513e592c122419799866add35f3f39b2025-02-03T01:03:09ZengWileyCase Reports in Medicine1687-96271687-96352011-01-01201110.1155/2011/916859916859Legionnaires' Disease with Facial Nerve PalsyShailesh R. Basani0Salwa Mohamed Ahmed1Eyassu Habte-Gabr2Department of Internal Medicine, Hurley Medical Center, Flint, MI 48503, USADepartment of Internal Medicine, Hurley Medical Center, Flint, MI 48503, USADepartment of Internal Medicine, Hurley Medical Center, Flint, MI 48503, USALegionnaires' disease is primarily a pneumonic process caused by Legionella pneumophilia, a gram-negative aerobic bacillus but also has multiple system involvement. The most common manifestation is encephalopathy suggesting a generalized brain dysfunction but focal neurological manifestations have been reported. We report a patient with Legionella pneumonia associated with cerebellar dysfunction and unilateral facial nerve weakness. 51-year-old previously healthy male presented with shortness of breath, cough, slurred speech, and unsteadiness on feet associated with malaise, fevers and myalgias. Patient's family reported facial asymmetry for 2 days. Patient had no significant medical history and was not on any medication. He denied smoking, alcohol or illicit drug use. Chest X-ray showed bilateral lower lobe infiltrates. Urinary antigen assay for Legionella pneumophilia serogroup 1 was positive. Patient was started on intravenous moxifloxacin. On day 5 the patient was discharged home and continued oral moxifloxacin for two weeks. After the two weeks, his respiratory symptoms, gait ataxia and dysarthria resolved. We report the first case of Legionnaires' disease with cerebellar dysfunction and seventh nerve palsy. Legionnaires' disease should be considered in patients with any neurological symptoms in the setting of pneumonia. Failure to recognize and treat the infection may lead to poor outcomes.http://dx.doi.org/10.1155/2011/916859
spellingShingle Shailesh R. Basani
Salwa Mohamed Ahmed
Eyassu Habte-Gabr
Legionnaires' Disease with Facial Nerve Palsy
Case Reports in Medicine
title Legionnaires' Disease with Facial Nerve Palsy
title_full Legionnaires' Disease with Facial Nerve Palsy
title_fullStr Legionnaires' Disease with Facial Nerve Palsy
title_full_unstemmed Legionnaires' Disease with Facial Nerve Palsy
title_short Legionnaires' Disease with Facial Nerve Palsy
title_sort legionnaires disease with facial nerve palsy
url http://dx.doi.org/10.1155/2011/916859
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