Legionellosis is the infection caused by bacteria of the genus Legionella , including a non-pneumonic influenza-like syndrome, and Legionnaires’ disease is a more serious illness characterized by pneumonia. Legionellosis is becoming increasingly important as a public health problem throughout the world; although it is an underreported disease, studies have consistently documented a high incidence. In addition, health costs associated with the disease are high. Diagnosis of Legionnaires’ disease is based mainly on the detection of Legionella pneumophila serogroup 1 antigen in urine. However, there have been advances in detection tests for patients with legionellosis. New methodologies show greater sensitivity and specificity, detect more species and serogroups of Legionella spp., and have the potential for use in epidemiological studies. Testing for Legionella spp. is recommended at hospital admission for severe community-acquired pneumonia, and antibiotics directed against Legionella spp. should be included early as empirical therapy. Inadequate or delayed antibiotic treatment in Legionella pneumonia has been associated with a worse prognosis. Either a fluoroquinolone (levofloxacin or moxifloxacin) or a macrolide (azithromycin preferred) is the recommended first-line therapy for Legionnaires’ disease; however, little information is available regarding adverse events or complications, or about the duration of antibiotic therapy and its association with clinical outcomes. Most published studies evaluating antibiotic treatment for Legionnaires’ disease are observational and consequently susceptible to bias and confounding. Well-designed studies are needed to assess the usefulness of diagnostic tests regarding clinical outcomes, as well as randomized trials comparing fluoroquinolones and macrolides or combination therapy that evaluate outcomes and adverse events.

Introduction:Sepsis is a worldwide condition that affects nearly 30 million people and causes about 6 million deaths per year. QuickSOFA (qSOFA) has limitations in identifying at-risk patients in the emergency room. There is no known association of inferior vena cava diameter measured through Point-of-Care Ultrasound (POCUS) and mortality in septic patients. Methods: We included 39 septic patients admitted to the emergency room that received a POCUS evaluation with IVC diameter measures. One attending performed all ultrasound evaluations. Patients were analyzed according to non-dilated IVC (less than 20 mm) and dilated (more than or equal to 20 mm). Results: Overall in-hospital mortality was 33%, more frequent in the dilated IVC group (66,7% vs 27,3%) without statistical significance. The dilated IVC group had non-significant more frequencies of mechanical ventilation, ICU admission and use of vasopressors. Early-mortality (defined as less than 72 hours) was more frequent in the non-dilated group (70%) vs the dilated group (0%) with a significant p-value 0.01. Conclusion: Septic patients in the emergency room with a POCUS IVC diameter less than 20 mm are more likely of early mortality within 72 hours of admission. This finding must be confirmed with prospective research and controlling confounders.