Intravenous levofloxacin (500 mg twice daily) and oral oseltamivir (150 mg twice daily) were administered. On the second day, hypoxemia, hypotension and renal failure developed; norepinephrine was administered after fluid challenge. For persistent hypoxemia she was ventilated in the prone-supine position for 12 hour intervals daily. Tests of the urine for legionella antigens were positive. Azithromycin (500 mg twice daily) was added her treatment.