CTICasesLegionella pneumophila Pneumonia
Imaging findings
A patient with cough and fever and a negative COVID test had vague consolidation, predominantly in the left lung, that over about 24 hours rapidly became bilateral, more central, confluent, and fluffy with air bronchograms, and eventually extensive with intubation. Cultures identified Legionella pneumophila, an isolated case without an associated outbreak.
Key takeaways
Rapidly progressive consolidation that begins largely unilateral and becomes bilateral within about a day should prompt consideration of Legionella, a cause of community-acquired bacterial pneumonia, and reminds that not everything bilateral is COVID. The speed of progression is a key discriminating clue.
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