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)

Although liver tests are frequently disturbed in Legionnaires' disease, jaundice occurs rarely except as a terminal event. The authors report the case of a 68 year-old man with jaundice as a presenting feature of the disease. Jaundice deepened rapidly until death a few days later. Drugs and other causes of cholestasis could be ruled out. An early liver biopsy was performed. The liver was histologically normal except for mitochondrial margination in the hepatocytes. No Legionella could be demonstrated by direct fluorescent assay. These findings suggest that: jaundice in Legionnaires' disease is not related to direct bacterial insult, cholestasis is probably consecutive to endotoxinemia, the mitochondrial margination, a rare histologic finding, could result from Legionnaires' disease. This last point needs confirmation by further studies.
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PMID:[Severe jaundice in Legionnaires' disease: a case with early hepatic biopsy]. 358 74

Legionella infections are getting increasingly important as causes of severe pneumonias or of acute respiratory insufficiency. Consumptive or immunosuppressive underlying diseases such as diabetes mellitus, cardiac insufficiency, alcohol-induced liver damage, malignant tumours or drug-induced immunosuppression after organ transplantation, are among the risk factors. Diagnosis is based on direct identification of the pathogen from body secretions by means of direct immunofluorescence. The serological immunoresponse often takes place long after outbreak of the disease or fails entirely to appear and is therefore only suitable for retrospective confirmation. Therapy of choice is an intravenous administration of erythromycin. There are now increasing pointers to the efficiency of fluoroquinolone antibiotics, such as ciprofloxacin. We report on the course of a severe case of legionnaire's disease with multiple organ failure occurring in a patient after bone marrow depression induced by anti-inflammatory drugs. Treatment erythromycin resulted in a marked cholestasis, so that antibiotic treatment was changed to ciprofloxacin. This therapy as well as the supportive intensive-care treatment eventually led to the patient's complete recovery. Based on the case report, fundamental aspects of diagnostics, antibiotic treatment, intensive-care treatment and prognosis of severe cases of legionellosis are discussed.
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PMID:[Severe legionellosis after abuse of anti-inflammatory drugs--diagnostic and intensive care aspects based on a case report]. 763 62

Sixty-four consecutive patients who underwent endoscopic sphincterotomy (ES) for common bile duct stones were reviewed. In the early phase, duct clearance was confirmed in 39 patients (61%). In the majority (21 patients), the stone/stones passed spontaneously after ES. The most common cause of failure was inability to perform ES (12 patients). After ES, only two patients needed early surgery for obstruction. One more patient was operated on because the stone was too big for extraction or spontaneous passing.--Ten patients with probably retained stones after ES were followed for six months to three years. Bile duct obstruction recurred in three of them: two were treated successfully with extracorporeal shock wave lithotripsy and one underwent repeated ES and stone extraction. The complication rate was low. One female patient died of Legionella pneumonia, but the relationship between the death and the procedure remained uncertain. One female patient needed emergency surgery for massive bleeding: she recovered normally. Nasobiliary drain or any kind of stenting were not used and there was no case of cholangitis after ES. Altogether 12 patients needed surgery because of failure of the endoscopic treatment. There was no mortality or severe complications in these operations.
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PMID:Endoscopic treatment of common bile duct stones. Experience of 64 consecutive patients. 832 31