Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sporadic deaths from Legionnaires' disease may escape detection at autopsy. Known epidemiological and clinical features of the disease should arouse suspicion and prompt appropriate bacteriological studies. The pathological findings in Legionnaires' disease are almost entirely confined to the lungs and are not distinct from any other severe bacterial bronchopneumonia. The causative organism, Legionella pneumophila, is difficult to identify on a Gram stain but will stain nonspecifically with the Giemsa, Warthin-Starry, and Dieterle techniques. The direct fluorescent antibody method allows specific identification of Legionella in paraffin-embedded tissue sections.
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PMID:Legionnaires' disease at autopsy. 617 Nov 59

Infection of guinea-pigs by intranasal (i.n.) instillation of 10(9) viable organisms of two newly isolated strains of Legionella pneumophila (74/81, serogroup 1; 166/81, serogroup 3) did not induce disease, but 10(4) organisms administered as a small particle aerosol (less than 5 microns diameter) produced a fatal widespread broncho-pneumonia within 3 days. Milder illness and less extensive bronchopneumonia were also produced in rhesus monkeys and marmosets by one of these two strains (74/81). Mice were resistant to induction of disease by aerosols of both these two strains, though organisms did persist in the lungs for at least 4 days. Both of these L. pneumophila strains were pathogenic for guinea-pigs by aerosol infection over a wide range of doses but the serogroup 1 type strain (NCTC 11192) was not. There was no mortality after infection of guinea-pigs by intranasal instillation of any of these strains but all proved to be fatal after intraperitoneal (i.p.) injection of large doses. Guinea-pigs, rhesus monkeys and marmosets exposed to aerosol infection with L. pneumophila provide relevant models for studying the pathogenesis of Legionnaires' disease.
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PMID:Aerosol infection of animals with strains of Legionella pneumophila of different virulence: comparison with intraperitoneal and intranasal routes of infection. 640 78

Guinea pigs, rhesus monkeys and marmosets infected with Legionella pneumophila in small particle aerosols developed an acute fibrinopurulent bronchopneumonia. Changes from 24 hr included exudation into alveoli of protein-rich, often fibrinous fluid and many polymorphonuclear leucocytes (PMN) and macrophages. Damage to alveolar capillary endothelium consisted of widespread cytoplasmic swelling and vesiculation, but necrosis of endothelium and the associated alveolar epithelium was focal and less common. Phagocytosis of L. pneumophila organisms was predominantly by macrophages, but the bacteria were also seen in PMN. Free organisms were present in alveoli and capillary lumina at all stages of the infection but were not observed in lung parenchymal cells. Some infected macrophages and PMN became necrotic and lysed to release intact bacteria. In all species of experimental animal, intracytoplasmic aggregations of granular material, believed to be glycogen, were seen frequently in macrophages and PMN which had phagocytosed L. pneumophila. These deposits of glycogen may reflect either an increased energy demand by the host cell or an interference with its carbohydrate metabolism.
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PMID:Ultrastructure of pulmonary alveoli and macrophages in experimental Legionnaires' disease. 685 36

Over a 2 1/2 year period, 61 clinical specimens from 41 patients with pneumonia of uncertain etiology were evaluated for the presence of Legionella pneumophila (serogroups 1 to 4) by immunofluorescent antibody techniques. In 13 of 19 patients with Legionnaires' disease, the diagnosis was established by fluorescent antibody (FA) staining of lung biopsies, pleural fluids, or respiratory tract secretions. In the 19 patients with Legionnaires' disease, the diagnosis was confirmed by isolation of L pneumophila by in vitro culture techniques in five or by measurement of serum antibody titers in 17. Although the FA staining technique was of limited sensitivity (68 percent), it was highly specific: no patients with non-Legionnaires' pneumonia had a false-positive fluorescent stain. In addition, the FA staining of lung tissue was positive only when performed during the first nine days of antimicrobial therapy and when an acute bronchopneumonia was noted histologically. In cases of a nonspecific interstitial pneumonitis, FA stain was always negative, and the diagnosis could be confirmed only by serum antibody measurements. Tests for serogroups 1 to 4 with a polyvalent conjugate showed that L. pneumophila serogroup 1 was the predominant strain detected in pneumonia of uncertain etiology in the Detroit area.
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PMID:Direct immunofluorescence in the diagnosis of Legionnaires' disease. 701 23

A 71-year-old patient living in a street where major road works were taking place developed diffuse bronchopneumonia with changes in hepatic and renal biochemical tests. Since neutrophilia was moderate and all bacteriological investigations were negative, the patient was given erythromycin and was tested for antibodies directed against Legionella pneumophila. The titers of these antibodies rose from 32 to 2048 after one month. The patient was cured.
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PMID:[Legionnaire's disease contracted in Brussels. One case (author's transl)]. 701 98

Pontiac fever, a unique epidemiologic form of legionellosis, is characterized by a short (one- to two-day) incubation period and a self-limited grippe-like illness without pneumonia. In 1968, the first documented outbreak of this syndrome affected persons who had entered a health department building in Pontiac, Michigan. Epidemiologic analyses clearly implicated as airborne agent and suggested that evaporative condenser water aerosols being disseminated by a defective air conditioning system played a key role in the outbreak. Guinea pigs that were exposed in the building and to laboratory aerosols of evaporative condenser water developed bronchopneumonia. Legionella pneumophilia (serogroup 1) was isolated from the exposed guinea pigs' lungs. Paired acute and convalescent serum specimens from 37 patients were tested by the indirect fluorescent antibody technique using L. pneumophila serogroup 1 antigen, and 31 (84%) had rises in titer from less than 32 to greater than or equal to 64.
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PMID:Pontiac fever: isolation of the etiologic agent (Legionella pneumophilia) and demonstration of its mode of transmission. 730 69

Antibody titres against Legionella pneumophila (serogroups 1 and 2) were determined by the indirect immunofluorescence test on 206 patients with various forms of bronchopulmonary disease. In one third of cases there was a very weak titre (1:32 to 1:64), a moderately to markedly elevated one against one or both bacterial strains (greater than or equal to 1:128) in 4%. In one of four cases with a titre greater than or equal to 1:512 Legionnaires' disease, contracted via an air-conditioning unit, was suspected. In another case there was probably chronic Legionnaires' disease with subsequent pulmonary fibrosis. In the remaining two cases chronic Legionnaires' disease was the likely diagnosis, the clinical picture being one of nonspecific bronchopneumonia. These findings suggest that the causative organism of Legionnaires' disease is widespread also in Southern Germany and that the disease does not always lead to severe pneumonic complications.
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PMID:[Legionnaires' disease: a cause of pulmonary fibrosis and bronchopulmonary disease? (author's transl)]. 736 35

From March 1977 to December 1978, postmortem examination was performed at Wadsworth Veterans Administration Medical Center for 20 patients who had had nosocomially acquired Legionnaires' disease. Seventeen patients died during the acute illness due to Legionnaires' disease, and three patients died after clinical resolution of the acute process. The only consistent postmortem findings were limited to the lungs. Confluent bronchopneumonia, and less frequently lobar pneumonia, was present in most cases. Although a spectrum of microscopic pulmonary findings was observed, the characteristic histologic features of acute Legionnaires' disease were an extensive intra-alveolar exudation of macrophages and neutrophils in varying proportions, erythrocytes, and fibrin. Lysis of the inflammatory cells was frequently found. Areas of coagulative necrosis of the lung parenchyma and edematous thickening of the alveolar septa were typically seen. Microscopy of lung tissue from the three patients who died after clinical resolution of the acute process revealed organized pneumonia, with patchy organization of the intra-alveolar exudate and focal obliteration of the alveolar septal framework. Associated postmortem findings were fibrinous endocarditis in one case and hemorrhagic infarction of the adrenal glands in two cases. Electron-microscopic examination of the lungs revealed as many as 23 separate bacillary profiles within a single macrophage. Septate binary fission or spore-like structures were not observed.
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PMID:Legionnaires' disease. Postmortem pathologic findings of 20 cases. 736 72

A patient with bladder carcinoma metastatic to lung and brain died of pneumonia. Autopsy examination showed a confluent bronchopneumonia with several small abscesses and acute pyelonephritis with abscess formation. Legionella pneumophila, serogroup 4, was isolated in pure culture from lung tissue postmortem and was also shown by direct immunofluorescence in the kidney and spleen. In the kidney, the organism was noted in areas of acute pyelonephritis. This represents the first case of an extrathoracic inflammatory lesion associated with L. pneumophila.
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PMID:Pyelonephritis associated with Legionella pneumophila, serogroup 4. 744 90

A new small animal model of experimental Legionnaires' disease is described in which the reconstitution of SCID-Beige mice with human peripheral blood leucocytes permits the in-vivo growth of Legionella pneumophila in the lungs of aerosol-challenged mice. Following infection, viable bacterial counts within the lungs of mice increased from 10(5) cfu/lung at the time of inoculation to a maximum of 10(10) cfu/lung by 48 h post-inoculation. Two types of disease were detected in the lungs of infected SCID-Beige mice. An acute exudative bronchiolitis and bronchopneumonia were seen in the most severely affected mice and, in the less severely affected mice, lesions of subacute or chronic disease were seen with thickening of alveolar walls and consolidation of lung tissue. Human cells did not appear to be involved directly in the pathology but were required for the establishment of infection. Immunohistological staining of lung tissue revealed substantial amounts of bacterial antigen distributed in a pattern similar to that seen in human Legionnaires' disease.
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PMID:Experimental Legionnaires' disease in SCID-Beige mice reconstituted with human leucocytes. 779 Dec 9


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