Can Legionella cause endocarditis?

Can Legionella cause endocarditis? Are there documented cases that legionella bacteria have migrated to the heart causing vegetations on the heart valves and requiring valve replacement?

Yes, numerous cases of hospital-acquired legionella endocarditis have been described – the largest series is from Stanford University. The source was the drinking water of the hospital.

Legionella is transmitted to the heart in 2 ways: bacteremia from hospital-acquired pneumonia or possibly contiguous spread from the use of contaminated water post-cardiac surgery. If you have such a case, it may be reportable as a case report in the peer-review literature. The water supply of the hospital must be cultured for legionella, and ideally, the results of Legionella serology and urinary antigen should be available for the patient. Pericarditis has also been reported.