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A 5-cm right lower-lobe pneumatocele later emerged, followed by two right-sided pneumothorax episodes managed with surgical bullectomy. The pneumatocele resolved spontaneously by discharge, emphasizing radiological monitoring and surgical readiness.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/a-case-of-legionella-pneumonia-complicated-by-pneumatoceles-and-pneumothorax-open-access-case-report/407997/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/a-case-of-legionella-pneumonia-complicated-by-pneumatoceles-and-pneumothorax-open-access-case-report/407997.png","ImageObject",300,407,{"name":42,"@type":43},"Franzy","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-31","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What complications developed in the patient after Legionella pneumonia?","Question",{"text":63,"@type":64},"The patient developed a pneumatocele (a thin-walled, air-filled cyst) and then two episodes of right-sided pneumothorax.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was Legionella pneumonia initially treated, and what was the early response?",{"text":68,"@type":64},"The patient was treated with intravenous levofloxacin, which led to initial improvement in the pneumonia.",{"name":70,"@type":61,"acceptedAnswer":71},"Why were systemic corticosteroids started during clinical deterioration?",{"text":72,"@type":64},"Progressive hypoxemia with diffuse ground-glass opacities and traction bronchiectasis suggested secondary interstitial involvement, most likely organizing pneumonia, so prednisolone was initiated.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},407997,1790816647,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":102,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},2336478945519,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Review began 10/16/2025  \nReview ended 11/25/2025  \nPublished 11/30/2025  \n© Copyright 2025  \nShimizu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98133  \nOpen Access Case Report  \nA Case of Legionella Pneumonia Complicated by Pneumatoceles and Pneumothorax  \nMaako Shimizu 1, Yuichiro Shimoyama 1 , Kentaro Ishikura 1 , Kenji Motohashi 1, Yoshitaka Tomoda 1 1. General Internal Medicine, Itabashi Chuo Medical Center, Tokyo, JPN  \nCorresponding author: Yoshitaka Tomoda, [yoshisoph@gmail.com](yoshisoph@gmail.com)  \nAbstract  \nWe report a rare case of Legionella pneumonia complicated by pneumatocele and recurrent pneumothorax. A previously healthy man in his 70s was diagnosed with Legionella pneumonia and treated with levofloxacin, resulting in initial improvement. However, he developed progressive hypoxemia with diffuse ground-glass opacities and traction bronchiectasis, requiring corticosteroid therapy. A 5-cm pneumatocele subsequently appeared in the right lower lobe, followed by two episodes of right-sided pneumothorax. Surgical bullectomy was performed to control the recurrence. The pneumatocele resolved spontaneously by discharge. Pneumatoceles are typically associated with necrotizing infections but have not been previously reported following Legionella pneumonia. This case underscores a previously undocumented structural complication and highlights the importance of radiological monitoring and surgical readiness in selected patients with post-Legionella respiratory deterioration.  \nCategories: Internal Medicine, Infectious Disease, Pulmonology  \nKeywords: legionella pneumonia, lung cyst, pneumatocele, pneumothorax ptx, recurrent pneumothorax  \nIntroduction  \nLegionella pneumophila is a recognized cause of severe community-acquired pneumonia. While acute pulmonary manifestations are well described, delayed complications such as interstitial lung disease, organizing pneumonia, or cystic changes are rare [1] . Pneumatoceles, which are thin-walled, air-filled cysts, are typically associated with Staphylococcus aureus infection or trauma but are rarely reported with atypical pathogens such as Legionella. Secondary pneumothorax following cystic changes has been described in viral pneumonias, including COVID-19, but rarely in Legionella infection [2] . We present a case of Legionella pneumonia complicated by pneumatoceles and recurrent pneumothorax, underscoring the importance of radiological follow-up.  \nCase Presentation  \nA 72-year-old man with only hypertension and otherwise healthy presented with a five-day history of fever and progressive fatigue. On arrival, his body temperature was 39°C, and his oxygen saturation was 95% on 3 L via nasal cannula. Chest auscultation revealed coarse crackles in the right lung field. Laboratory findings were significant for leukocytosis (WBC 11,900/μL), hyponatremia (Na 127 mEq/L), and an elevated CRP level (30 .74 mg/dL) (Table 1) .  \nHow to cite this article  \nShimizu M , Shimoyama Y , Ishikura K, et al. (November 30 , 2025) A Case of Legionella Pneumonia Complicated by Pneumatoceles and Pneumothorax. Cureus 17(11): e98133. DOI 10.7759/cureus.98133  \nTest 1st Admission 2nd Admission Normal Range Units  \nWhite blood cell count  \nHemoglobin  \nPlatelet  \nTotal bilirubin  \nAspartate aminotransferase  \nAlanine aminotransferase  \nLactate dehydrogenase  \nCreatinine  \nBlood urea nitrogen  \nSodium  \nPotassium  \nChloride  \nC-reactive protein  \n11 ,900 14.8  \n131 ,000 1.6 39  \n30  \n164  \n0.8  \n13.4  \n127  \n4.2  \n91  \n307.4  \n7 ,400  \n11.7  \n589 ,000  \n0.7  \n12  \n9  \n196  \n0.6  \n9.7  \n136  \n4.4  \n97  \n145.8  \n3 ,300–8 ,600  \n13.7–16.8  \n158 ,000–348 ,000  \n0.3–1.2  \n8–40  \n5–45  \n124-222  \n0.61–1.08  \n8–23  \n136–147  \n3.5–5.0  \n98–108  \n0–1.4  \nμL  \ng/dL  \nμL  \nIU/L  \nIU/","cbCaic5wPNqFSNF7","https://ap.wps.com/l/cbCaic5wPNqFSNF7","pdf",4822064,"English","# Abstract\n# Introduction\n# Case Presentation\n## Laboratory findings and imaging\n## Diagnosis and treatment course\n## Readmission and differential diagnosis","[{\"question\":\"What complications developed in the patient after Legionella pneumonia?\",\"answer\":\"The patient developed a pneumatocele (a thin-walled, air-filled cyst) and then two episodes of right-sided pneumothorax.\"},{\"question\":\"How was Legionella pneumonia initially treated, and what was the early response?\",\"answer\":\"The patient was treated with intravenous levofloxacin, which led to initial improvement in the pneumonia.\"},{\"question\":\"Why were systemic corticosteroids started during clinical deterioration?\",\"answer\":\"Progressive hypoxemia with diffuse ground-glass opacities and traction bronchiectasis suggested secondary interstitial involvement, most likely organizing pneumonia, so prednisolone was initiated.\"}]","A Case of Legionella Pneumonia Complicated by Pneumatoceles and Pneumothorax - Open Access Case Report | PDF",1790577597,15]