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In North America and Europe, Legionella species are reported in 2% to 15% of patients hospitalized with community-acquired pneumonia (CAP). The diagnosis of legionellosis is difficult because cultures have a low yield and the urinary antigen test has low sensitivity. Although empirical antibiotic therapy for legionellosis is recommended when the condition is suspected or pneumonia is severe, this practice could lead to antibiotic overuse. Consequently, several clinical predictive scores have been developed.
Using data from a multinational observational database of hospitalized adults with CAP, researchers sought to validate a score based on six dichotomized variables: fever >39.4°C, C-reactive protein >187 mg/L, lactate dehydrogenase >227 mm…