A Case of Legionella Pneumonia Complicated by Pneumatoceles and Pneumothorax

We report a rare case of <i>Legionella</i> pneumonia complicated by pneumatocele and recurrent pneumothorax. A previously healthy man in his 70s was diagnosed with <i>Legionella</i> pneumonia and treated with levofloxacin, resulting in initial improvement. However, he developed progressive hypoxemia with diffuse ground-glass opacities and traction bronchiectasis, requiring corticosteroid therapy. A 5-cm pneumatocele subsequently appeared in the right lower lobe, followed by two episodes of right-sided pneumothorax. Surgical bullectomy was performed to control the recurrence. The pneumatocele resolved spontaneously by discharge. Pneumatoceles are typically associated with necrotizing infections but have not been previously reported following <i>Legionella</i> pneumonia. This case underscores a previously undocumented structural complication and highlights the importance of radiological monitoring and surgical readiness in selected patients with post-<i>Legionella</i> respiratory deterioration.