[Legionella pneumophila pneumonia masked by simultaneous demonstration of further non-specific pneumonia pathogens].

We are presenting a case of Legionella type I pneumonia, accidentally diagnosed by selective culture with simultaneous identification of pneumococci, meningococci and Hemophilus influenzae in the general sputum culture. A 35-year-old patient had been hospitalized with the typical signs of Legionnaires' disease (severe pneumonia with symptoms of cardiac, hepatic, renal, and cerebral involvement), following several days of prodromi. The routine sputum bacteriology according to DGHM standards first revealed pneumococci, meningococci and H. influenzae in significant numbers. Later, the special culture medium named after Edelstein (BMPA alpha-medium), routinely inoculated in our laboratory, grew Legionella pneumophila type I. Legionella type I-specific serum antibodies in IIFT confirmed the diagnosis of Legionnaires' disease. After therapy with amoxicillin plus clavulanic acid and cefoxitin, the temperature declined and laboratory as well as radiologic findings returned to normal. Without the culture of L. pneumophila from expectorated sputum, the diagnosis of Legionnaires' disease would not have been found.