[A case of repeated upper gastrointestinal bleeding secondary to Legionella pneumonia].

Shinya Sugimoto, Yukihiro Yoshimura, Natsuo Tachikawa

Research output: Contribution to journalReview articlepeer-review


A 70-year-old woman admitted for nausea and diarrhea was diagnosed with Legionella pneumonia based on chest X-ray and urinary antigen testing. Despite severe complications, she recovered thanks to ciprofloxacin administration. On hospital day 8, she went into hypovolemic shock necessitating emergency gastrointestinal (GI) fiberscopy, which showed active lower gastric bleeding. The exposed artery was clipped endoscopically and proton pump inhibitor was started. At hospital day 16, the woman's active GI bleeding recurred, requiring further endoscopic clipping. On hospital day 20, oozing occurred in the middle gastric body. To prevent recurrent bleeding, extensive gastrectomy was done on hospital day 28. Legionella pneumonia is common pneumonia, as are GI symptoms in Legionella pneumonia, but GI bleeding is rare. Only cases of GI bleeding secondary to Legionella pneumonia have been reported in Japan, in addition to our case, and four of the 5 died after GI bleeding, indicating the dismal prognosis. The relationship between Legionella pneumonia and GI bleeding, although uncertain and rare, requires especially close observation.

Original languageEnglish
Pages (from-to)284-288
Number of pages5
JournalKansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases
Issue number3
Publication statusPublished - 2011 May
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine


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