To the Editor.
—An ever-enlarging spectrum of illness is caused by Legionnaires' disease. The patient described had a serologically documented case of Legionnaires' disease in association with a massive pericardial effusion, a complication that, to my knowledge, has not been previously reported.
Report of a Case.
—A 22-year-old man was admitted to the hospital with a ten-day history of fever, chills, generalized myalgias, pleuritic chest pain, dyspnea, and near syncope. Physical examination findings disclosed an acutely ill man with a temperature of 38 °C (101.4 °F); pulse rate, 96 beats per minute; respirations, 24/min; and blood pressure, 130/80 mm Hg, with a 10-mm paradoxical pulse. The lungs had a bibasilar pleural rub and right basilar egophony. A two-component pericardial rub was heard on cardiovascular examination. Laboratory data included the following values: hemoglobin, 14.8 g/dL; hematocrit, 44.4%; WBCs, 13,300/cu mm, with 56 polymorphonuclear cells, four band forms, 28 lymphocytes, six atypical