A 59-year-old man presents to a major tertiary hospital with chest pain and electrocardiographic abnormalities including diffuse ST-segment elevations. During the intensive care course the patient develops increasing respiratory failure. The discussants on this roundtable case report address diagnostic challenges, therapeutic aims, and goals of treatment in order to meet expected quality standards.
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References
1.
AntzelevitchCBrugadaP. Brugada syndrome: Report of the second consensus conference: Endorsed by the Heart Rhythm Society and the European Heart Rhythm Association. Circulation. 2005;111:659-670, erratum 112:e74.
2.
EwigSTorresA. Severe community-acquired pneumonia [review]. Curr Opin Crit Care. 2002;8:453-460.
3.
ApisarnthanarakAMundyLM. Etiology of community-acquired pneumonia [review]. Clin Chest Med. 2005;26:47-55.
HakimFATleyjehIM. Severe adenovirus pneumonia in immunocompetent adults: A case report and review of the literature. Eur J Clin Microbiol Infect Dis. 2008;27:153-158.
6.
StoutJEYuVL. Legionellosis. N Engl J Med. 1997;337:682-687.
7.
DiederenBM. Legionella spp. and Legionnaires’ disease. J Infect. 2008;56:1-12.
8.
NeilKBerkelmanR. Increasing incidence of legionellosis in the United States, 1990-2005: Changing epidemiologic trends. Clin Infect Dis. 2008;47:591-599.
9.
FiumefreddoRZaborskyRHaeuptleJ. Clinical predictors for Legionella in patients presenting with community-acquired pneumonia to the emergency department. BMC Pulm Med. 2009Jan19;9:4.
10.
CunhaBA. Atypical pneumonias: Current clinical concepts focusing on Legionnaires’ disease [review]. Curr Opin Pulm Med. 2008;14:183-194.
11.
Pedro-BotetMLSabriàM. Legionellosis [review]. Semin Respir Crit Care Med. 2005;26:625-634.
12.
KimKWGooJMLeeHJ. Chest computed tomographic findings and clinical features of legionella pneumonia. J Comput Assist Tomogr. 2007;31:950-955.
13.
TanMJTanJSHamorRHFileTMJrBreimanRF. The radiologic manifestations of Legionnaire’s disease. The Ohio Community-Based Pneumonia Incidence Study Group. Chest. 2000;117:398-403.
14.
HuiYHigaFHibiyaKFurugenM. Computed tomographic features of 23 sporadic cases with Legionella pneumophila pneumonia. Eur J Radiol. 2009May5. [Epub ahead of print]
ShimadaTNoguchiYJacksonJL. Systematic review and metaanalysis: Urinary antigen tests for Legionellosis. Chest. 2009Mar24. [Epub ahead of print]
18.
LoensKBeckTUrsiD. Evaluation of different nucleic acid amplification techniques for the detection of M. pneumoniae, C. pneumoniae and Legionella spp. in respiratory specimens from patients with community-acquired pneumonia. J Microbiol Methods. 2008;73:257-262.
WilkinsonMWoodheadMA. Guidelines for community-acquired pneumonia in the ICU [review]. Curr Opin Crit Care. 2004;10:59-64.
21.
LevinAS. Nosocomial legionellosis: Prevention and management. Expert Rev Anti Infect Ther. 2009;7:57-68.
22.
MouchtouriVAGoutzianaGKremastinouJHadjichristodoulouC. Legionella species colonization in cooling towers: Risk factors and assessment of control measures. Am J Infect Control. 2009Aug19. [Epub ahead of print]