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Extracorporeal life support for acute respiratory distress syndrome due to severe Legionella pneumonia.
[legionellosis]
Legionella
is
a
common
cause
of
community-acquired
pneumonia
(
CAP
)
and
is
second
only
to
Pneumococcal
pneumonia
as
a
cause
of
severe
CAP
that
requires
treatment
in
an
intensive
care
unit
.
We
report
a
case
series
of
patients
with
severe
Legionella
pneumonia
who
developed
the
acute
respiratory
distress
syndrome
(
ARDS
)
,
failed
to
improve
with
mechanical
ventilation
alone
and
required
extracorporeal
life
support
(
ECLS
)
.
We
performed
a
retrospective
study
of
all
patients
treated
with
ECLS
at
our
institution
for
severe
ARDS
as
a
result
of
Legionella
pneumonia
from
1994
to
2006
.
A
total
of
twelve
patients
with
a
diagnosis
of
Legionella
pneumonia
were
treated
with
veno-
venous
(
VV
)
ECLS
over
this
time
period
.
Nine
of
these
twelve
(
75
%
)
were
successfully
treated
and
weaned
off
ECLS
and
8
patients
(
67
%
)
survived
to
hospital
discharge
.
Two
(
13
%
)
died
of
multisystem
organ
failure
,
one
patient
(
8
%
)
died
from
global
hypoxic
encephalopathy
and
one
(
8
%
)
was
weaned
from
ECLS
,
but
ultimately
died
of
liver
failure
.
Renal
failure
requiring
some
form
of
continuous
dialysis
occurred
in
seven
patients
(
58
%
)
and
the
survival
for
this
sub-set
of
patients
was
43
%
.
Extracorporeal
life
support
for
severe
ARDS
associated
with
Legionella
pneumonia
is
an
effective
treatment
option
when
mechanical
ventilation
fails
,
especially
when
introduced
early
in
the
course
.
Diseases
Validation
Diseases presenting
"common cause"
symptom
achondroplasia
acute rheumatic fever
adrenomyeloneuropathy
allergic bronchopulmonary aspergillosis
alpha-thalassemia
aniridia
aromatase deficiency
benign recurrent intrahepatic cholestasis
cadasil
child syndrome
coats disease
congenital adrenal hyperplasia
congenital toxoplasmosis
cushing syndrome
erdheim-chester disease
esophageal adenocarcinoma
esophageal squamous cell carcinoma
fabry disease
familial hypocalciuric hypercalcemia
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
lamellar ichthyosis
legionellosis
liposarcoma
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
pendred syndrome
primary hyperoxaluria type 1
pyruvate dehydrogenase deficiency
scrub typhus
systemic capillary leak syndrome
thoracic outlet syndrome
typhoid
von hippel-lindau disease
wiskott-aldrich syndrome
zellweger syndrome
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