Legionella infection in pregnancy: imitator of HELLP syndrome, presenting as acute respiratory failure and septic shock

Abstract

Background: Legionnaires' disease in pregnancy may cause severe maternal complications. Hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome is a disorder associated with significant maternal and fetal morbidity and mortality. Several medical conditions have been described as imitators of this syndrome, presenting with similar laboratory abnormalities. Case presentation: A healthy, multiparous woman presented at 26 weeks' gestation with fever, headache and general malaise, rapidly progressing to septic shock and respiratory collapse. Laboratory evaluation revealed similar abnormalities to those seen with HELLP syndrome. Emergent cesarean delivery was performed for worsening maternal and fetal conditions. Following delivery, infection with Legionella was diagnosed on urinary antigen testing. Supportive care was administered in the intensive care unit. Conclusion(s): Legionnaires' disease should be considered in gravidas presenting with rapidly deteriorating respiratory status, septic shock and laboratory abnormalities mimicking HELLP syndrome.Copyright © 2019 Walterde Gruyter GmbH, Berlin/Boston.