Miyashita et al evaluated patients in Japan with Legionella pneumonia and features distinguishing these patients from those with other community-acquired pneumonias. The authors are from multiple institutions from Japan.
The authors found that performance of various measures depended on the prevalence of the various causes of CAP in the differential diagnosis (Streptococcus pneumoniae, Mycoplasma, other).
Laboratory predictors of Legionella:
(1) high C-reactive protein (> 187 mg/L)
(2) low serum sodium (< 133 mmol/L)
Performance of the two laboratory findings:
• The area under the ROC curve was 0.84.
Other laboratory findings:
(1) A high serum LDH was found in both Legionella and Streptococcus pneumoniae but not Mycoplasma.
(2) A high temperature was found in both Legionella and Mycoplasma but not with Streptococcus pneumoniae.
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