How long will Legionnaires’ cause fevers after being discharged from the hospital?

My friend (previously healthy 53 year old male) was diagnosed with Legionella via a positive urine culture. He was hospitalized and the first three doses of antibiotics were intravenous and he was then discharged on oral form (Levaquin-250 mg).


Today is his seventh day out of the hospital. He still has fevers and sweats, albeit not as intense. He is still quite fatigued. His appetite is better. He never had respiratory or GI symptoms. He has a doctor’s appointment in three days. How long can I expect his fevers and fatigue to last? I was very unimpressed by the hospital staff on their directions.

The information that you have provided is insufficient to answer your question with confidence. However, it appears that he may have been discharged prematurely. The criteria that we use for discharge are their fever response and ability to take food. So, many patients can be discharged on day five on oral antibiotics.

On the other hand, Levaquin is the right antibiotic, and he is improving. The dose should be 500 or 750 mg (not 250 mg). He also has no GI symptoms, which is a good sign. If he had nausea or diarrhea, intravenous antibiotics should have been continued. By the time he sees his physician, his temperature should be normal. If not, he should be re-evaluated. Fatigue will persist for a few weeks, but should gradually resolve given his previous good state of health.

Did he have recent travel history? If so, the water that he consumed may have been the source of Legionella. Good luck!