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Legionnaires’ Disease

Andrew G. Alexander, MD, Kenneth A. Ballou, MD, FAAFP and Maegen Dupper, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Legionnaires’ disease was named for an epidemic of lower respiratory tract disease at an American Legion convention in Philadelphia in 1976. The previously unrecognized causative bac...

DIAGNOSIS

  • Illness ranges from asymptomatic seroconversion and mild febrile illness to severe pneumonia.

  • Wound infections with Legionella also reported

  • Incubation period is 2 to 14 days.

HISTORY

  • Signs and ...

TREATMENT

GENERAL MEASURES

  • Supportive care:

    • Oxygenation, hydration, and electrolyte balance with antibiotic therapy

  • Extrapulmonary complications and higher mortality in patients with AIDS

  • In severe pneumo...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Monitor respiratory status, hydration, and electrolyte status closely.

  • Chest radiography lags behind the clinical status and may not help with mo...

REFERENCES

1
Adams DA, Thomas KR, Jajosky RA, et al; for Nationally Notifiable Infectious Conditions Group. Summary of notifiable infectious diseases and conditions—United States, 2015. MMWR Morb Morta...

ADDITIONAL READING

  • Mandell LA, Wunderink RG, Anzueto A, et al; for Infectious Diseases Society of America, American Thoracic Society. Infectious Diseases Society of America/American Thoracic Society c...

CODES

ICD10

  • A48.1 Legionnaires’ disease

  • A48.2 Nonpneumonic Legionnaires’ disease [Pontiac fever]

ICD9

482.84 Pneumonia due to Legionnaires’ disease 

SNOMED

  • 312403005 Legionnaire’s disease (disorder)

  • 19588900...

CLINICAL PEARLS

  • Legionella is an intracellular organism that can only be grown on BCYE agar.

  • Serology is not useful in early stages of the disease (an increase in Legionella antibody titers cannot be d...

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