{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T16:32:14Z","timestamp":1787157134639,"version":"build-2736575974"},"reference-count":55,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: Legionella pneumophila is a leading cause of community- and hospital-acquired pneumonia (HAP\/CAP), although the clinical and radiological features associated with infection remain incompletely defined. This study aimed to identify clinical, comorbidity-related, and chest computed tomography (CT) features associated with L. pneumophila pneumonia in hospitalized adults with community-acquired pneumonia (CAP). Methods: A retrospective case\u2013control study was conducted at a tertiary-care university hospital in Italy between January 2019 and August 2025. Eighty patients positive for L. pneumophila were compared with 79 controls negative for L. pneumophila. Demographic, clinical, microbiological, and radiological data were collected, and factors independently associated with infection were evaluated using multivariable logistic regression analysis. Results: Patients with L. pneumophila infection exhibited a greater comorbidity burden, particularly heart failure, and were more frequently smokers. Bilateral lung involvement and hilar\/mediastinal lymphadenopathy were significantly more common among Legionella-positive patients, whereas overall pulmonary complications and bilateral pleural effusion were more frequently observed in controls. Multivariable analysis identified comorbidity burden as an independent positive predictor of L. pneumophila infection, while intensive care unit admission, oxygen therapy, and pulmonary complication score were independently associated with a lower likelihood of infection. Conclusions: The integration of comorbidity assessment with readily available chest CT findings may help raise clinical suspicion of L. pneumophila pneumonia and support consideration of appropriate diagnostic testing.<\/jats:p>","DOI":"10.3390\/pathogens15080866","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T16:12:58Z","timestamp":1787155978000},"page":"866","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comorbidity Burden and Radiological Features Associated with Legionella pneumophila Pneumonia: A Retrospective Case\u2013Control Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8086-6362","authenticated-orcid":false,"given":"Nicola","family":"Serra","sequence":"first","affiliation":[{"name":"Audiology Section, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa Maria Assunta","family":"Fasciana","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D\u2019Alessandro, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4418-5855","authenticated-orcid":false,"given":"Paola","family":"Di Carlo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D\u2019Alessandro, University of Palermo, 90127 Palermo, Italy"},{"name":"Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico \u201cP. Giaccone\u201d, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Giammanco","sequence":"additional","affiliation":[{"name":"Legionella Reference Laboratory, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1992-1796","authenticated-orcid":false,"given":"Antonio","family":"Cascio","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D\u2019Alessandro, University of Palermo, 90127 Palermo, Italy"},{"name":"Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico \u201cP. Giaccone\u201d, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Pipit\u00f2","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D\u2019Alessandro, University of Palermo, 90127 Palermo, Italy"},{"name":"Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico \u201cP. Giaccone\u201d, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"De Luca","sequence":"additional","affiliation":[{"name":"Spinal Unit at the P.O. \u201cVilla delle Ginestre\u201d of the ASP Palermo, Via Castellana, 145, 90135 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6767-8823","authenticated-orcid":false,"given":"Caterina","family":"Carollo","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D\u2019Alessandro, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D\u2019Alessandro, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina Maria","family":"Federico","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D\u2019Alessandro, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2779-7879","authenticated-orcid":false,"given":"Consolato Maria","family":"Sergi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Grassedonio","sequence":"additional","affiliation":[{"name":"Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8808-379X","authenticated-orcid":false,"given":"Tommaso Vincenzo","family":"Bartolotta","sequence":"additional","affiliation":[{"name":"Section of Emergency Radiology Unit of Policlinico University Hospital \u201cPaolo Giaccone\u201d, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention (CDC) (2026, July 01). 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