Background: Pneumonia caused by the atypical pathogen Legionella pneumophila during pregnancy is a rare occurrence that carries substantial maternal and fetal risk.
Case: A 36-year-old woman, G3P2002, presented at 33(2/7) weeks' gestation with 6 days of worsening cough, fever, and shortness of breath. She was admitted to the intensive care unit and suffered acute respiratory failure requiring mechanical ventilation. Aggressive diagnostic efforts showed sero- positivity for Legionella IgM. The patient recovered following antibiotic therapy and cesarean delivery.
Conclusion: Successful treatment of Legionnaires disease requires a high degree of clinical suspicion and prompt empirical treatment when severe community-acquired pneumonia is encountered. In severe cases that are refractory to antimicrobial treatment, cesarean delivery may help resolve compromised maternal respiratory status.