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September 1981

Legionnaires' Disease Associated With Massive Pericardial Effusion

Author Affiliations

Huntsville, Ala

Arch Intern Med. 1981;141(10):1385. doi:10.1001/archinte.1981.00340100141031

To the Editor.  —An ever-enlarging spectrum of illness is caused by Legionnaires' disease. The patient described had a serologically documented case of Legionnaires' disease in association with a massive pericardial effusion, a complication that, to my knowledge, has not been previously reported.

Report of a Case.  —A 22-year-old man was admitted to the hospital with a ten-day history of fever, chills, generalized myalgias, pleuritic chest pain, dyspnea, and near syncope. Physical examination findings disclosed an acutely ill man with a temperature of 38 °C (101.4 °F); pulse rate, 96 beats per minute; respirations, 24/min; and blood pressure, 130/80 mm Hg, with a 10-mm paradoxical pulse. The lungs had a bibasilar pleural rub and right basilar egophony. A two-component pericardial rub was heard on cardiovascular examination. Laboratory data included the following values: hemoglobin, 14.8 g/dL; hematocrit, 44.4%; WBCs, 13,300/cu mm, with 56 polymorphonuclear cells, four band forms, 28 lymphocytes, six atypical

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