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Pulmonary Legionnaires' Disease Without Pneumonia

Fredy P. Roland, MD
JAMA. 1981;246(3):214. doi:10.1001/jama.1981.03320030012010.
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To the Editor.—  Storch et al (1981; 245:587), evaluating the chest roentgenograms in sporadic cases of Legionnaires' disease diagnosed by serological findings, commented that the roentgenograms would be indistinguishable from those showing pneumococcal pneumonia. They obtained only 18 of 100 sets of roentgenograms they sought, explaining that the patients whose physicians sent them (18) may have been different from those whose physicians did not. Maybe some of the roentgenograms not sent were normal. Tsai et al,1 describing the Philadelphia epidemic, mentioned "mild respiratory illness without radiographic evidence of pneumonia" in 28 patients. Many persons exposed to Legionella may not acquire the severe pneumonia associated with epidemic and sporadic cases.

Report of a Case.—  We report the case of a 34-year-old female technologist who "felt sick" one day. Two days later she had a temperature of 38 °C with a sore throat, chills, and a dry cough. Physical examination showed

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