L. pneumophila infection presenting with panniculitis
Primary cutaneous and subcutaneous infection caused by Legionella pneumophila is rare and the diagnosis is challenging. One such case has been reported in the journal BMC Infectious Diseases.

According to the authors, this is the first case of L. pneumophila infection manifesting with panniculitis, possible myositis, and myocarditis in the absence of pneumonia.

A 38-year-old woman with systemic lupus erythematosus and myasthenia gravis treated with prednisolone and azathioprine presented to with low-grade fever, diarrhoea, and indurated skin lesions on both thighs. Initial examination showed plaques on both inner thighs.

MRI revealed myositis and swelling of the skin and subcutaneous tissue. Diagnosis of panniculitis due to L. pneumophila was carried out by histopathology, Gram stain, and 16S rRNA gene sequencing method of tissue biopsy from multiple sites on both thighs. Myocarditis was diagnosed by echocardiography.

The final diagnosis was disseminated extrapulmonary legionellosis. Treatment comprised intravenous azithromycin for 3 weeks and the skin lesions, myositis and myocarditis resolved. Oral azithromycin and ciprofloxacin were continued for 3 months to ensure eradication of the organism. The patient’s overall condition improved.

Read about the case in detail here: https://pxmd.co/PRAB7
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