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Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over a 24-month period, 274 patients with community-acquired pneumonia were hospitalized in Departments of Medicine at hospitals in Bordeaux, Lyon, Marseille, and Toulouse. Etiology of the pneumonia was determined either by organism identification or by indirect immunofluorescence in only 139 cases (51%). The most frequently isolated etiological agents were Streptococcus pneumoniae (34 cases), Legionella pneumophila (29 cases) and Mycoplasma pneumoniae (24 cases). The majority of patients with legionellosis were male (79%), middle aged (mean age: 53 years), and living in urban areas (69%). Their clinical features were atypical and did not differ from those of other pneumonias. Four patients with legionellosis (13.8%) died. L. pneumophila was isolated directly in only three instances. The study confirms the high prevalence of legionellosis (20%) among pneumonias of identified etiology. The fact that these cases had an atypical clinical presentation and that isolation of the organism was difficult reinforce the need to apply the CDC criteria for the interpretation of positive serological titers.
Infection 1987
PMID:Prevalence of legionellosis among adults: a study of community-acquired pneumonia in France. 369 3

Specimens from 490 patients with suspected legionellosis from many parts of New Zealand were studied. Most of these were sera, but 36 specimens including material from lungs, pleural fluid and sputa were also examined. The sera were tested for the presence of antibodies to Legionella pneumophila serogroups 1 to 6 and Legionella micdadei. Serological evidence of legionellosis was found in 49 patients. Antibodies to L. pneumophila serogroup 6 predominated, while those to L. micdadei and L. pneumophila serogroup 1 were noted in smaller numbers. Antibodies to serogroups 2, 3, 4 and 5 of L. pneumophila were not often encountered.
Infection
PMID:Serological studies on patients with suspected legionellosis in New Zealand. 389 43

We are presenting a case of Legionella type I pneumonia, accidentally diagnosed by selective culture with simultaneous identification of pneumococci, meningococci and Hemophilus influenzae in the general sputum culture. A 35-year-old patient had been hospitalized with the typical signs of Legionnaires' disease (severe pneumonia with symptoms of cardiac, hepatic, renal, and cerebral involvement), following several days of prodromi. The routine sputum bacteriology according to DGHM standards first revealed pneumococci, meningococci and H. influenzae in significant numbers. Later, the special culture medium named after Edelstein (BMPA alpha-medium), routinely inoculated in our laboratory, grew Legionella pneumophila type I. Legionella type I-specific serum antibodies in IIFT confirmed the diagnosis of Legionnaires' disease. After therapy with amoxicillin plus clavulanic acid and cefoxitin, the temperature declined and laboratory as well as radiologic findings returned to normal. Without the culture of L. pneumophila from expectorated sputum, the diagnosis of Legionnaires' disease would not have been found.
Infection
PMID:[Legionella pneumophila pneumonia masked by simultaneous demonstration of further non-specific pneumonia pathogens]. 390 21

Upper respiratory tract infections are the most common types of infectious diseases among adults. It is estimated that each adult in the United States experiences two to four respiratory infections annually. The morbidity of these infections is measured by an estimated 75 million physician visits per year, almost 150 million days lost from work, and more than $10 billion in costs for medical care. Serotypes of the rhinoviruses account for 20 to 30 percent of episodes of the common cold. However, the specific causes of most upper respiratory infections are undefined. Pneumonia remains an important cause of morbidity and mortality for nonhospitalized adults despite the widespread use of effective antimicrobial agents. There are no accurate figures on the number of episodes of pneumonia that occur each year in ambulatory patients. In younger adults, the atypical pneumonia syndrome is the most common clinical presentation; Mycoplasma pneumoniae is the most frequently identified causative agent. Other less common agents include Legionella pneumophila, influenza viruses, adenoviruses, and Chlamydia. More than half a million adults are hospitalized each year with pneumonia. Persons older than 65 years of age have the highest rate of pneumonia admissions, 11.5 per 1,000 population. Pneumonia ranks as the sixth leading cause of death in the United States. The pathogens responsible for community-acquired pneumonias are changing. Forty years ago, Streptococcus pneumoniae accounted for the majority of infections. Today, a broad array of community-acquired pathogens have been implicated as etiologic agents including Legionella species, gram-negative bacilli, Hemophilus influenzae, Staphylococcus aureus and nonbacterial pathogens. Given the diversity of pathogenic agents, it has become imperative for clinicians to establish a specific etiologic diagnosis before initiating therapy or to consider the diagnostic possibilities and treat with antimicrobial agents that are effective against the most likely pathogens.
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PMID:Epidemiology of community-acquired respiratory tract infections in adults. Incidence, etiology, and impact. 401 85

Plasmid and peptide analysis was used to characterize Legionella pneumophila strains isolated in the study of a small cluster of cases in hospitalized patients. The isolates from the Denver Veterans' Administration Medical Center could be clearly separated into three groups. Two of the three clinical isolates were found to be plasmidless, as were five of 19 environmental isolates. The patient isolates had plasmid and peptide profiles which were identical to the showerhead isolates to which each patient was exposed. Thus, the data suggest that the patients acquired their disease strains from environmental sites in their particular hospital wing, and that each wing of the building had its own unique flora of Legionella strains. The results also confirm the usefulness of using both these techniques when tracing transmission patterns of nosocomial disease.
Infection
PMID:Combined plasmid and peptide analysis of clinical and environmental Legionella pneumophila strains associated with a small cluster of Legionnaires' disease cases. 404 43

Soluble or particulate microbial antigens are excreted in the urine in many systemic infectious processes. The ease with which urine antigens can be concentrated has facilitated their detection by immunologic methods. The group and type-specific bacterial polysaccharides are among the best studied examples of urinary excretion of microbial antigens. These polysaccharides are often present in the urine as low molecular weight fragments (70,000 daltons or less) and in some instances may represent degradation products of the native polysaccharides. Urine polysaccharides are sufficiently immunoreactive to be detectable by simple precipitin and agglutination techniques in a large percentage of patients with infections due to certain pyogenic bacteria including Haemophilus influenzae and group B streptococci. Both polysaccharide and protein antigens have been detected in the urine by immunologic methods in numerous other infections including parasitic, viral, and spirochetal diseases. Detection of a thermostable antigen in the urine of patients with Legionnaires' disease by radio- and enzyme-linked immunoassays represents an important recent advance. The exact role of immunologic tests for etiologic diagnosis in infectious diseases is not established, but will undoubtedly be influenced by developments such as monoclonal antibody technology and better availability of standardized immunologic reagents.
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PMID:Urine as an antigen reservoir for diagnosis of infectious diseases. 630 1

Pneumonia remains the leading infectious disease-related cause of death among the elderly. Streptococcus pneumoniae is the most frequent pathogen isolated from aged individuals with community-acquired pneumonia. Other common bacteria that cause this disease include Haemophilus influenzae and Legionella pneumophila. Manifestations of pneumonia in the elderly can be subtle and result in delayed recognition and treatment. Gram stain evaluation and culture of non-contaminated expectorated sputum remain the conventional techniques to guide initial antibiotic selection. While the presence of a new infiltrate on chest X-ray confirms the clinical diagnosis of pneumonia, the radiographic appearance of the infiltrate cannot accurately define the etiologic agent. Specific therapeutic measures include administration of appropriate antibiotics, correction of fluid and electrolyte imbalances, nutritional support and treatment of concomitant disorders. Preventive measures include use of influenza vaccine, amantadine and pneumococcal vaccine.
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PMID:Community-acquired bacterial pneumonia in the elderly. 637 23

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

Antibody titres to L. pneumophila serogroup 1 were followed for 2 years with indirect immunofluorescence test with polyvalent (mostly IgG) conjugate (49 patients) and with specific IgM conjugate (35 patients). Significant titre rises were found in all patients to both Ig-classes. IgM-antibodies were detectable in 13 patients within one week. In all 25 patients that were possible to evaluate in this respect, the maximum titre of both classes was reached within 3 weeks. Although the geometric mean titre for both Ig-classes followed the general pattern for infectious diseases, a sufficient number of patients had persisting high titres of both IgG and IgM making it impossible to designate a reliable value of a single titre to be used as diagnostic evidence of ongoing or recent Legionnaires' Disease.
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PMID:The pattern of immunoglobulins with special reference to IgM in Legionnaires' disease patients during a 2 year follow-up period. 663 31

We investigated the in vitro effect of various members of the genus Legionella on human peripheral mononuclear cells. All the strains tested induced the generation of strong procoagulant activity (tissue factor) when incubated for a prolonged period of time with pure mononuclear cell suspensions. This effect was dependent on the number of bacteria. The production of mononuclear cell procoagulant activity was also observed after the addition of bacteria to citrated whole blood. Escherichia coli 0111:B4 showed similar activity, but Staphylococcus aureus was much less effective. These findings suggest that the presence of endotoxin-like substance(s) in the outer cell wall of Legionellae could contribute to the stimulation of mononuclear cells. The production of tissue factor, a potent trigger of blood clotting, by these cells could help us to understand the mechanism(s) responsible for the activation of intravascular coagulation associated with severe legionellosis.
Infection 1982
PMID:Legionella pneumophila and related organisms induce the generation of procoagulant activity by peripheral mononuclear cells in vitro. 675 34


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