Overwhelming respiratory failure associated with Legionella pneumophila

Four patients were admitted to the medical intensive care unit at King Khalid University Hospital [KKUH] with overwhelming respiratory failure. Extensive investigations revealed serological evidence of Legionella infection. Three patients required intubation and mechanical ventilation. All patients received erythromycin; rifampin was added to two patients. Two patients survived and two patients died. We report, for the first time in Saudi Arabia, four cases of Legionella pneumophila with severe respiratory failure