# A Case of Legionella Pneumonia Complicated by Pneumatoceles and Pneumothorax

## TL;DR

A rare case of Legionella pneumonia led to pneumatoceles and pneumothorax, requiring surgical intervention and highlighting the need for close monitoring.

## Contribution

This is the first reported case of pneumatoceles and pneumothorax complicating Legionella pneumonia.

## Key findings

- A 70-year-old man with Legionella pneumonia developed pneumatoceles and recurrent pneumothorax.
- Surgical bullectomy was required to manage the pneumothorax, and the pneumatocele resolved by discharge.
- Pneumatoceles are a previously undocumented complication of Legionella pneumonia.

## Abstract

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.