Pretty sure this is a case of Legionella. The fact that it didn't show up on culture but a "highly specialized" medium (in hindsight buffered charcoal yeast) yielded gram-negative rods put Legionella on my radar. The headache and dry cough also line up with it but the macrolides threw me off since I thought they were treated with fluoroquinolone.
But the sketchy video for macrolides includes Legionella as a target so it worked out.
epiglotittiesAgree! FA also says that treatment is w/ macrolide or quinolone. Just to add something, a UW question (dont know Qid) specified that sputum gram stain for Legionella will show many neutrophils but few or no organisms, exactly how they presented it in this case. +1
submitted by โadong(144)
Pretty sure this is a case of Legionella. The fact that it didn't show up on culture but a "highly specialized" medium (in hindsight buffered charcoal yeast) yielded gram-negative rods put Legionella on my radar. The headache and dry cough also line up with it but the macrolides threw me off since I thought they were treated with fluoroquinolone. But the sketchy video for macrolides includes Legionella as a target so it worked out.