Why You Should Wear A Mask When Gardening

[hlthe2b]

3. Not clear the organism was Legionella. It could also have been Tularemia (spread by infected rabbits)

and that is more likely in the US. Often misdiagnosed. Fortunately for that patient, several of the antibiotics effective against Legionella would likewise treat Tularemia (Francisella tularensis). In the West, this is not uncommon but can be mistaken in its earlier febrile stage with plague so there is probably more awareness--especially where there has been some wild rabbit die-off. But anyone gardening, mowing, digging, or landscaping should be aware of the risks in their area. No mention that it was considered, but even in Australia, it likely should have been.


Abstract
https://pubmed.ncbi.nlm.nih.gov/9097380/

Tularemia pneumonia may complicate the various clinical presentations of tularemia, or present as an uncommon zoonosis. Approximately 200 cases of tularemia are reported in the United States per year, and 10% to 20% present with pneumonia either as a primary event or as a complication of ulceroglandular or typhoidal tularemia. Tularemia pneumonia also occurs with the other tularemic forms, glandular, oculoglandular, and oropharyngeal tularemia as a result of secondary bacteremic spread to the lungs. Pneumonia usually occurs within 2 days to months after infection. The mortality rate of primary tularemic pneumonia and pneumonia complicating typhoidal tularemia is high. The clinical and roentgenographic presentations of tularemia pneumonia are highly variable and is one of the zoonotic atypical pneumonias. Tularemic pneumonia may mimic fungal and bacterial pneumonias, tuberculosis, or malignancy. The diagnosis of tularemic pneumonia should be considered in any patient presenting with an atypical pneumonia with the finding of an ulcer and/or lymphadenopathy and a history of outdoor activity. Serum agglutination tests and ELISA are the basis of serological diagnosis. Francisella tularensis can be cultured from the sputum, skin ulcer, pleural fluid, and the lymph nodes, but cultures should not be obtained because of the danger to laboratory personnel. The drug preferred for treatment of tularemic pneumonia is streptomycin for 1 to 2 weeks.