{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T22:43:32Z","timestamp":1783464212803,"version":"3.55.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,6]],"date-time":"2021-06-06T00:00:00Z","timestamp":1622937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,6]],"date-time":"2021-06-06T00:00:00Z","timestamp":1622937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Legionella bacteria is a common cause of pneumonia, but the infection may affect several organs in the most serious cases. A systemic involvement ab initio could be non-specific, leading to a diagnostic misinterpretation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 33-year-old woman had been complaining of mental confusion, restlessness, aggressiveness, and, subsequently, hirsutism. After 3 weeks, the patient developed pneumonia and died during the hospitalization. The autopsy examination revealed a multi-organ necrotizing exudative disease involving the lung, the heart and the brain. The microbiological tests of tracheal aspirate were positive for <jats:italic>Legionella pneumophila<\/jats:italic> serotype 1.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The Legionella infection may show a proteiform clinical course and an extra-pulmonary manifestation may be the first sign of the disease. Herein, we report a case of Legionella infection in a young female, presenting with non-specific neurological symptoms and hirsutism at onset, misdiagnosed as a metabolic disease.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06247-9","type":"journal-article","created":{"date-parts":[[2021,6,6]],"date-time":"2021-06-06T21:03:23Z","timestamp":1623013403000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Legionnaires\u2019 disease arising with hirsutism: case report of an extremely confusing event"],"prefix":"10.1186","volume":"21","author":[{"given":"Gabriella","family":"Serio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8954-5888","authenticated-orcid":false,"given":"Francesco","family":"Fortarezza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Pezzuto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Santacroce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Nazzaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Bellitti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenica","family":"Cavone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Marzullo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Vimercati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,6]]},"reference":[{"issue":"10016","key":"6247_CR1","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/S0140-6736(15)60078-2","volume":"387","author":"BA Cunha","year":"2016","unstructured":"Cunha BA, Burillo A, Bouza. Legionnaires\u2019 disease. Lancet. 2016;387(10016):376\u201385. https:\/\/doi.org\/10.1016\/S0140-6736(15)60078-2.","journal-title":"Lancet"},{"issue":"7","key":"6247_CR2","doi-asserted-by":"publisher","first-page":"670","DOI":"10.3390\/ijerph14070670","volume":"14","author":"MT Montagna","year":"2017","unstructured":"Montagna MT, De Giglio O, Cristina ML, Napoli C, Pacifico C, Agodi A, et al. Evaluation of Legionella air contamination in healthcare facilities by different sampling methods: an Italian multicenter study. Int J Environ Res Public Health. 2017;14(7):670. https:\/\/doi.org\/10.3390\/ijerph14070670.","journal-title":"Int J Environ Res Public Health"},{"key":"6247_CR3","first-page":"e000540","volume":"17","author":"BA Cunha","year":"2019","unstructured":"Cunha BA, Dieguez B, Osakwe N. Legionnaire\u2019s disease presenting with encephalitis, myoclonus, and seizure: successful treatment with doxycycline. 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Written informed consent to the use of clinical information and tissues for additional studies and for research purpose was obtained from the patient\u2019s next-of-kin. Such consent has been designed in accordance with the internal policy approved by the ethical committee of University of Bari.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient\u2019s next-of-kin gave written consent for their relative\u2019s personal, clinical details and images to be published in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"532"}}