{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:10:11Z","timestamp":1756293011266,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,28]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>A 44-year-old right-handed man with a 5-day history of non-productive cough associated with subjective fevers\/chills and night sweats presented to the emergency department with slurred speech. Radiography and urine antigen testing confirmed the diagnosis of <jats:italic>Legionella pneumonia<\/jats:italic>. The hospital course was complicated by acute hypoxic respiratory failure that required 7\u2009days of invasive mechanical ventilation. Following extubation, the patient had dysarthria and developed new parkinsonism features. Brain imaging revealed a non-specific focal lesion in the left frontal lobe of unclear significance. Ciprofloxacin was decided as the final antibiotic of choice for its favourable central nervous system profile. Levodopa\u2013carbidopa was initiated to help activate the basal ganglia. The patient had complete resolution of pneumonia and transient parkinsonism. He was able to regain most of his baseline functional status with intensive rehabilitation.<\/jats:p>","DOI":"10.1136\/bcr-2019-233152","type":"journal-article","created":{"date-parts":[[2020,1,8]],"date-time":"2020-01-08T03:55:14Z","timestamp":1578455714000},"page":"e233152","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Transient parkinsonism associated with acute Legionnaires\u2019 disease"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1144-4120","authenticated-orcid":false,"given":"Johnny S","family":"Su","sequence":"first","affiliation":[{"name":"School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Honsberger","sequence":"additional","affiliation":[{"name":"MetroHealth Medical Center, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad G","family":"Husnain","sequence":"additional","affiliation":[{"name":"MetroHealth Medical Center, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,1,7]]},"reference":[{"key":"2025082703363089000_13.1.e233152.1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2003.015669"},{"key":"2025082703363089000_13.1.e233152.2","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/00005792-198409000-00004","article-title":"Neurologic manifestations of Legionnaires' disease","volume":"63","author":"Johnson","year":"1984","journal-title":"Medicine"},{"key":"2025082703363089000_13.1.e233152.3","doi-asserted-by":"publisher","DOI":"10.1159\/000008231"},{"key":"2025082703363089000_13.1.e233152.4","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2010.75"},{"key":"2025082703363089000_13.1.e233152.5","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2334-12-225","article-title":"Legionella pneumophila infection presenting as headache, confusion and dysarthria in a human immunodeficiency virus-1 (HIV-1) positive patient: case report","volume":"12","author":"Robbins","year":"2012","journal-title":"BMC Infect Dis"},{"key":"2025082703363089000_13.1.e233152.6","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00007-10"},{"key":"2025082703363089000_13.1.e233152.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2008.08.001"},{"key":"2025082703363089000_13.1.e233152.8","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1001\/jamaneurol.2016.1043","article-title":"Enteroviral postencephalitic parkinsonism with evidence of impaired presynaptic dopaminergic function","volume":"73","author":"Toledano","year":"2016","journal-title":"JAMA Neurol"},{"key":"2025082703363089000_13.1.e233152.9","doi-asserted-by":"crossref","first-page":"696","DOI":"10.2174\/156652411797536660","article-title":"Gastrointestinal immune system and brain dialogue implicated in neuroinflammatory and neurodegenerative diseases","volume":"11","author":"Deretzi","year":"2011","journal-title":"Curr Mol Med"},{"key":"2025082703363089000_13.1.e233152.10","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2019.00122","article-title":"Inflammation, infectious triggers, and Parkinson's disease","volume":"10","author":"Caggiu","year":"2019","journal-title":"Front Neurol"},{"key":"2025082703363089000_13.1.e233152.11","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.nbd.2017.04.004","article-title":"Alpha-synuclein: Pathology, mitochondrial dysfunction and neuroinflammation in Parkinson\u2019s disease","volume":"109","author":"Rocha","year":"2018","journal-title":"Neurobiol Dis"},{"key":"2025082703363089000_13.1.e233152.12","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5368-11.2012"},{"key":"2025082703363089000_13.1.e233152.13","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.47.0857"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-233152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:36:36Z","timestamp":1756290996000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-233152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1,7]]},"published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1136\/bcr-2019-233152"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-233152","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}