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Atraumatic Splenic Rupture in Legionella pneumophila Pneumonia

A previously fit 46-year-old male handyman presented to a rural hospital with a cough, fever, and epigastric pain without peritonism. The patient was admitted medically with symptoms and radiological appearances consistent with atypical community-acquired pneumonia. During the first 48 hours of admi...

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Detalles Bibliográficos
Autores principales: Worku, Elliott, Adam Worku, Dominic
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10266911/
https://www.ncbi.nlm.nih.gov/pubmed/37323130
http://dx.doi.org/10.1155/2023/9625170
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author Worku, Elliott
Adam Worku, Dominic
author_facet Worku, Elliott
Adam Worku, Dominic
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description A previously fit 46-year-old male handyman presented to a rural hospital with a cough, fever, and epigastric pain without peritonism. The patient was admitted medically with symptoms and radiological appearances consistent with atypical community-acquired pneumonia. During the first 48 hours of admission, he suffered a significant haemodynamic deterioration and was transferred to the intensive care unit (ICU) for vasoactive support. Following stabilisation, urgent abdominal CT imaging demonstrated splenic rupture with haematoma in the absence of historical trauma. Emergency splenectomy was performed; the histopathological examination was unremarkable. Investigations for the presenting complaint confirmed Legionella pneumophila serotype 1 pneumonia by urinary antigen testing. The patient was extubated on postoperative day 2 and stepped down from ICU to complete a 14-day course of azithromycin. Atraumatic splenic rupture is a rarely described clinical entity. The process can be subdivided into pathological and nonpathological (spontaneous) cases. Pathological atraumatic splenic rupture may occur in the context of wide-ranging aetiologies, including bacterial pneumonia; however, the association with Legionella pneumophila serotype 1 is exceptional, with this representing the eighth case in the medical literature.
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spelling pubmed-102669112023-06-15 Atraumatic Splenic Rupture in Legionella pneumophila Pneumonia Worku, Elliott Adam Worku, Dominic Case Rep Infect Dis Case Report A previously fit 46-year-old male handyman presented to a rural hospital with a cough, fever, and epigastric pain without peritonism. The patient was admitted medically with symptoms and radiological appearances consistent with atypical community-acquired pneumonia. During the first 48 hours of admission, he suffered a significant haemodynamic deterioration and was transferred to the intensive care unit (ICU) for vasoactive support. Following stabilisation, urgent abdominal CT imaging demonstrated splenic rupture with haematoma in the absence of historical trauma. Emergency splenectomy was performed; the histopathological examination was unremarkable. Investigations for the presenting complaint confirmed Legionella pneumophila serotype 1 pneumonia by urinary antigen testing. The patient was extubated on postoperative day 2 and stepped down from ICU to complete a 14-day course of azithromycin. Atraumatic splenic rupture is a rarely described clinical entity. The process can be subdivided into pathological and nonpathological (spontaneous) cases. Pathological atraumatic splenic rupture may occur in the context of wide-ranging aetiologies, including bacterial pneumonia; however, the association with Legionella pneumophila serotype 1 is exceptional, with this representing the eighth case in the medical literature. Hindawi 2023-06-07 /pmc/articles/PMC10266911/ /pubmed/37323130 http://dx.doi.org/10.1155/2023/9625170 Text en Copyright © 2023 Elliott Worku and Dominic Adam Worku. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Worku, Elliott
Adam Worku, Dominic
Atraumatic Splenic Rupture in Legionella pneumophila Pneumonia
title Atraumatic Splenic Rupture in Legionella pneumophila Pneumonia
title_full Atraumatic Splenic Rupture in Legionella pneumophila Pneumonia
title_fullStr Atraumatic Splenic Rupture in Legionella pneumophila Pneumonia
title_full_unstemmed Atraumatic Splenic Rupture in Legionella pneumophila Pneumonia
title_short Atraumatic Splenic Rupture in Legionella pneumophila Pneumonia
title_sort atraumatic splenic rupture in legionella pneumophila pneumonia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10266911/
https://www.ncbi.nlm.nih.gov/pubmed/37323130
http://dx.doi.org/10.1155/2023/9625170
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