Legionella Pneumonia Complicated by Acute Respiratory Distress Syndrome Requiring Venovenous Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy Support: A Case Report

Legionella species is a common atypical bacterial pathogen in both community- and hospital-acquired pneumonia. Legionella pneumonia may lead to severe medical sequelae, such as acute respiratory distress syndrome (ARDS) and multiple organ failure. Herein, we report the case of a 54-year-old man with type 2 diabetes mellitus, hypertension, and coronary artery disease. He was diagnosed with Legionella pneumonia complicated by severe ARDS and acute kidney injury. He was successfully treated with antibiotics and venovenous extracorporeal membrane oxygenation (ECMO) in combination with continuous renal replacement therapy (CRRT) support. This case report highlights the usually underdiagnosed Legionella infection and its substantial presentation. Legionella pneumonia should be detected earlier, and appropriate ECMO referral should be considered for Legionella pneumonia-associated refractory respiratory failure. In Taiwan, there is a paucity of reported cases of Legionella pneumonia that progressed to ARDS and were successfully treated with venovenous ECMO and CRRT support.