When a 10-month-old girl arrived at a hospital in November 2025, she had spiked a fever and was breathing rapidly and shallowly. She recently had been diagnosed as having a rare autoinflammatory disease, and doctors learned she had been fed formula mixed using a device that blended powdered formula with warmed water stored in a reservoir.
Both the water in the device and the home tested positive for Legionella pneumophila, according to a case report published last week in Morbidity and Mortality Weekly Report. The infant’s experience with Legionnaires' disease highlights the danger of drinking resting warm water.
“Household devices that retain warm water are possible Legionella bacteria sources and might pose a health risk, especially for persons with immunocompromising conditions,” the authors wrote.
Boiling water helps prevent infection
In October 2025, the baby girl had been admitted to the hospital and diagnosed as having systemic-onset juvenile idiopathic arthritis macrophage activation syndrome, a potentially deadly condition in which immune cells overreact. Doctors treated her with immunosuppressant medications, and her health remained stable at follow-up visits.
When she visited the hospital on November 17, 2025, lung radiographs showed fluid in her upper left lobe, and testing revealed she was positive for L pneumophila. Doctors treated her with the antibiotics azithromycin and meropenem, and her condition improved. The girl was discharged on November 30 with parental instructions to give her oral levofloxacin, an antibiotic, for 21 days.
Household devices that retain warm water are possible Legionella bacteria sources and might pose a health risk, especially for persons with immunocompromising conditions.
On December 15, she returned to the hospital, where chest scans revealed new cavities in her left lung. Because her parents had stopped using the formula mixer, doctors suspected that her lingering troubles were related to her original infection. She was given azithromycin for six days and discharged with intravenous antibiotics.
Testing found Legionella bacteria in the mixing device and the filtered household water. While investigators did not test the water filter, they noted that such filters can also allow bacteria to flourish by eliminating chlorine or if people fail to maintain them correctly.
The authors recommend that infants with immunocompromising conditions receive formula made with water boiled to more than 158º Fahrenheit, mixed, and then cooled.