Two cases of Legionnaires' disease associated with continuous positive airway pressure therapy

摘要

To the Editor Sporadic cases and outbreaks of Legionella pneumophila usually are related to exposure to water-containing Legionella bacterium. Legionnaires' disease is transmitted by contaminated water in medical equipment, including oxygen humidifiers, nebulizers, and face masks, and has been extensively reported. Nevertheless, there has never been a reported case of Legionnaires' disease related to continuous positive airway pressure (CPAP). Herein, we describe two cases of the disease in patients who used this machine. 1. Patient 1 A 52-year-old woman presented with a fever, cough, and dyspnea. Her chest X-ray showed right upper lobe consolidation. Her respiratory status dramatically declined after X-ray, as her oxygen saturation dropped to 80%. She was intubated and admitted to the intensive care unit. Her medical history included chronic diabetes mellitus; hypertension; and obstructive sleep apnea, for which she used CPAP therapy at night. Further laboratory investigation revealed a positive urine Legionella antigen test. She was treated with levofloxacin; she responded well to the antibiotic and was extu-bated 4 days after the initiation of treatment with levofloxacin.