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Background  Because of a limited number of reports, we aimed to investigate the clinical characteristics of patients with  Legionella  pneumonia due to non- Legionella pneumophila  serogroup 1 and the diagnostic usefulness of the six-point scoring system for such patients compared with patients with pneumonia caused by  L. pneumophila  serogroup 1.    Methods  We retrospectively analysed patients diagnosed with  Legionella  pneumonia due to non- L. pneumophila  serogroup 1 between March 2001 and June 2016. We examined the clinical characteristics, including symptoms, laboratory findings, radiologic findings, pneumonia severity, initial treatment and prognosis. We also calculated scores using the six-point scoring system in these patients. Furthermore, we compared the clinical characteristics and six-point scores between non- L. pneumophila  serogroup 1 patients and  L. pneumophila  serogroup 1 patients among hospitalized community-acquired pneumonia patients enrolled prospectively between October 2010 and July 2016.    Results  Eleven patients had pneumonia due to non- L. pneumophila  serogroup 1; their median age was 66 years and 8 patients (72.7%) were male. The most common pathogen was  L. pneumophila  serogroup 3 (6/11), followed by  L. pneumophila  serogroup 9 (3/11),  L. pneumophila  serogroup 6 (1/11) and  L. longbeachae  (1/11). Non-specific symptoms, such as fever and cough, were common. Six patients (54.5%) had liver enzyme elevation, but no patient developed hyponatraemia at <130 mEq/L. Nine patients (81.8%) showed lobar pneumonia and 7 patients (63.6%) manifested with consolidation and ground-glass opacity. Patients with mild to moderate severity comprised 10 (90.9%) by CURB-65 and 5 (45.5%) by the Pneumonia Severity Index. Of all patients, 4 were admitted to the intensive care unit and 3 died despite appropriate empiric therapy. The clinical characteristics were not significantly different between non- L. pneumophila  serogroup 1 patients and  L. pneumophila  serogroup 1 patients ( n  = 23). At a cut-off value of ≥ 2 points, the sensitivity of the six-point scoring system was 54.5% (6/11) for non- L. pneumophila  serogroup 1 patients and 95.7% (22/23) for  L. pneumophila  serogroup 1 patients.    Conclusions  Cases of non- L. pneumophila  serogroup 1 pneumonia varied in severity from mild to severe and the clinical characteristics were often non-specific. The six-point scoring system was not useful in predicting such  Legionella  pneumonia cases.    Electronic supplementary material  The online version of this article (10.1186/s12890-017-0559-3) contains supplementary material, which is available to authorized users.

Legionella pneumonia due to non-Legionella pneumophila serogroup 1: usefulness of the six-point scoring system