A recent case of legionnaire’s disease linked to a dirty CPAP mask reaffirms that respiratory devices can be a reservoir for potentially fatal pathogens, researchers say.

A 77-year-old man presented to his GP with a fever, productive cough and increasing shortness of breath. 

He was diagnosed with community-acquired pneumonia and treated with broad spectrum antibiotics and non-invasive ventilation.

However throat swabs did not detect Bordetella pertussis, Mycoplasma pneumoniae, or any respiratory viruses.

Further investigations tested positive for Legionella pneumophila serogroup 1 (LP1) and he later died in hospital. 

Environmental health officers traced LP1 back to the man’s poorly maintained CPAP machine.

Figure 1: Respiratory device retrieved from case with biofilm on the internal filter

“The importance of respiratory devices as potential reservoirs of Legionella species may not be fully appreciated by a new generation of medical practitioners and respiratory physicians,” the researchers wrote in Communicable Diseases Intelligence.

The case highlighted the importance of ensuring that respiratory patients were taught the importance of good device maintenance and were made aware of the potential risks associated with not adhering to the cleaning instructions provided in the instruction manual, they said.