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Case Reports
. 2021 Jan 7;21(1):32.
doi: 10.1186/s12879-020-05715-y.

Legionnaire's disease presenting as bilateral central scotomata: a case report

Sho Yamada  1 , Takamasa Kitajima  2 , Satoshi Marumo  2 , Motonari Fukui  2
Affiliations
Case Reports

Legionnaire's disease presenting as bilateral central scotomata: a case report

Sho Yamada et al. BMC Infect Dis. .

Abstract

Background: Legionnaire's disease is one of the major causes of community-acquired pneumonia and is occasionally complicated by neurological symptoms. However, reports of ocular lesions due to Legionnaire's disease are limited.

Case presentation: We report the case of a patient with Legionnaire's disease presenting as bilateral central scotomata due to retinal lesions. The patient consulted due to fever and bilateral central scotomata, as well as other extrapulmonary symptoms. Optical coherence tomography (OCT) showed bilateral accumulations of fluid under the retina, and the patient was diagnosed with bilateral exudative retinal detachment. Later, Legionnaire's disease was confirmed by pulmonary infiltrates on chest imaging and positive urinary antigen for Legionella pneumophila. After administration of antibiotics, the bilateral central scotomata and bilateral subretinal fluid accumulations completely resolved, as did the other extrapulmonary symptoms and the pulmonary infiltrates. Thus, the bilateral central scotomata due to exudative retinal detachment were thought to be caused by Legionnaire's disease.

Conclusions: This case demonstrates that Legionnaire's disease can present as bilateral central scotomata. We may consider the possibility of extrapulmonary involvement complicating Legionnaire's disease when we encounter bilateral ocular lesions in patients with fever and pneumonia.

Keywords: Bilateral central scotomata; Case report; Exudative retinal detachment; Legionnaire’s disease; Ocular involvement.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Clinical course of the patient
Fig. 2
Fig. 2
Optical coherence tomography of both eyes before admission (a: right, b: left) and on day 10 (c: right, d: left). (a, b) Bilateral subretinal fluids (white arrows) under the macula. (c, d) Absence of bilateral subretinal fluids under the macula
Fig. 3
Fig. 3
Chest radiograph on admission showing infiltrates in the right lower lung field
Fig. 4
Fig. 4
Chest computed tomography on admission showing consolidation in the right lower lobe
See this image and copyright information in PMC

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