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)

The frequency of Legionnaires' disease among 586 cases of pneumonia that occurred in Iowa between fiscal years 1972 and 1977 was studied retrospectively on the basis of paired sera. The frequency of confirmed Legionnaires' disease was 4.1% and of presumptive Legionnaires' disease was 11.4%. Infections with the Legionnaires' disease (LD) bacterium were most frequent in the summer. Of the 22% of pneumonias for which a cause could be defined, Legionnaires' disease was third in frequency behind Mycoplasma pneumoniae and influenza A virus infections. Infections with the LD bacterium occurred in association with pneumonias in most age groups. The youngest patient with LD infection was a 5-year-old boy with pneumonia. The disease occurred 3.2 times more often in males than in females. In males, the frequency of confirmed and presumptive Legionnaires' disease increased steadily to plateau after the fourth decade at about 12% and 28%, respectively. In females the frequency of presumptive Legionnaires' disease was 7% to 16%, relatively evenly distributed over all age groups. Pneumonias associated with LD bacterium infection should be considered in the differential diagnosis of community-acquired pneumonias in most age groups.
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PMID:Legionnaires' disease in pneumonia patients in Iowa. A retrospective seroepidemiologic study, 1972-1977. 43 44

In February 1979 a 51 year old man fell will in Munich, displaying symptoms of an influenza-like illness which developed into pneumonia. The patient died eight days later of circulatory collapse which failed to respond to treatment, accompanied by high temperature, leucopenia and agranulocytosis. Typical rods detected in the lung tissue and histological sections by immunofluorescence indicated the possibility of a Legionella pneumophila infection. The pathogen isolated from the lung tissue on CYE agar was identified as L. pneumophila, serogroup I. The diagnosis was confirmed by the CDC, Atlanta. This is the first time this organism has been isolated in Central Europe from a case with a fatal outcome.
Infection 1979
PMID:[Legionnaires' disease in Germany (author's transl)]. 47 55

Stimulated by an outbreak of measles that was spread throughout a school by the ventilating system, we looked into the possibility of preventing this hazard in air conditioned buildings. The amount of air recirculated by air conditioning systems increases as the temperature difference between indoor and outdoor air increases and often exceeds 70 per cent. Germicidal u.v. radiation in central supply ducts seems almost ideally suited for disinfecting recirculated air, being effective, safe, and cheap. The effectiveness of disinfecting recirculated air in blocking person to person transmission of airborne infection can be predicted to be great at the beginning of a potential outbreak and negligible during an established epidemic. Infection introduced by the air conditioning process, recently implicated in causing Legionnaires' Disease, might also be prevented. Air disinfection would supplement immunization in the control of respiratory infection and might be cost effective.
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PMID:Indoor spread of respiratory infection by recirculation of air. 50 76

The pathology and histology are reported of five Scots who died of severe pneumonic illnesses after holidays in Spain, three in 1973 and two in 1977. There is strong evidence in favour of all the deaths having been due to the newly discovered Legionnaires' disease (LD) agent. The agent (or its soluble antigen) has been visualised in sections of lung tissue by fluorescent-antibody tests in all cases, and the agent has been identified by the Dieterle silver staining method in small numbers in all cases. Serological testing was possible in three of the patients, and two had very high antibody titres against the LD agent. Apart from the extensive and severe nature of the pathological process there is no feature to distinguish pulmonary infection by this agent from that due to more commonly known bacteria capable of causing lobar pneumonia. The severity and extensive nature of the process is partly a reflection of neglect in seeking treatment until late in the infection, and partly a reflection, as revealed in retrospect, on the use of the wrong antibiotic combination during treatment. Erythromycin has been recommended by other workers as the drug of choice against the LD agent. Infection by this organism is not confined to the USA or to Spain and is indigenous also in the United Kingdom.
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PMID:Pathology of five Scottish deaths from pneumonic illnesses acquired in Spain due to Legionnaires' disease agent. 71 9

The detection of travel-associated legionellosis can be extremely difficult; hence, an extensive case investigation is recommended in pneumonia-striken travellers and tourists, who are particularly at risk of acquiring the disease. On the Island of Ischia (Isola d'Ischia, Naples, Italy) a total of six cases of Legionnaires' disease occurred from 1986 to 1990. All patients (one man and two women from Germany, one Austrian woman, one Swiss man, and one Italian woman) had taken thermal baths and stayed in local hotels; they all experienced severe pneumonia, and three of them died. These cases were associated with hotels, and the hot-water supply was presumed to have transmitted the infection. Remedial procedures were applied to the hot-water plumbing of the hotels according to the WHO recommendations and were proved to be effective. The occurrences described in this paper stress the importance of rapid and accurate reporting of diagnosed cases to the country where the infection was probably acquired, in order to ensure early detection of endemic foci and emerging clusters of legionellosis.
Infection
PMID:Six cases of travel-associated Legionnaires' disease in Ischia involving four countries. 158 87

A 68-year-old male, having just returned from a two-week holiday on the Island of Ischia, developed unilateral pneumonia for which he was treated with oral amoxicillin-clavulanic acid and hospitalized within three days when the disease worsened and spread to both lungs. Despite parenteral amoxicillin-clavulanic acid (up to 2.2 g i.v. t.i.d.) the pneumonia spread rapidly over the next three days. Sputum cultures returned post mortem yielded Legionella pneumophila serogroup 1 and urine tests revealed the presence of Legionella antigen. Disk diffusion susceptibility testing on BCYE of the causative pathogen revealed zone diameters of inhibition of the clinical isolate exceeding 50 mm, indicating high susceptibility to this antibiotic combination. The therapeutic failure of amoxicillin-clavulanic acid should stimulate further reports and studies on the efficacy against legionellosis of this drug and similar beta-lactam inhibitor combinations as well as other beta-lactamase-stable beta-lactams.
Infection
PMID:Fatal Legionella pneumophila pneumonia: treatment failure despite early sequential oral-parenteral amoxicillin-clavulanic acid therapy. 158 91

Infection of peritoneal macrophages from susceptible A/J mice with Legionella pneumophila induced phosphorylation of a 76-kDa protein. The phosphorylation occurred when macrophages were infected with a virulent strain of L. pneumophila but did not occur when they were infected with an avirulent strain or with other bacteria such as either Pseudomonas aeruginosa or Salmonella typhimurium. Also, no phosphorylation of this protein was observed when macrophages were stimulated with either lipopolysaccharide or phorbol myristate acetate. However, phosphorylation did occur in macrophages infected with a virulent strain of L. pneumophila and treated with either erythromycin to inhibit growth or with cytochalasin D to inhibit uptake of L. pneumophila by macrophages. These results support the view that phosphorylation of this protein occurs during the early phases of interaction between L. pneumophila and macrophages. The role of this specific protein in the recognition, intracellular uptake, and growth of L. pneumophila in permissive macrophages remains to be clarified.
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PMID:Infection of macrophages with Legionella pneumophila induces phosphorylation of a 76-kilodalton protein. 163 15

Bronchoalveolar washout was performed in 130 patients with pneumonia during a period of 28 months. Microbiological investigation involved common bacteria, Legionella, fungi, viruses (Cytomegalovirus, herpes, RSV), Mycobacterium, and Pneumocystis carinii. Infection HIV was present in 75% of patients. The remaining patients had malignant diseases or severe pneumonia. The overall sensitivity of the technique was 65.4% and the positive predictive value was 92%. The technique was less sensitive in cases of bacterial pneumonia (sensitivity = 34.4%). This was attributed to the fact that 82.8% of these cases received antibiotic therapy. Pneumocystis carinii and Mycobacterium tuberculosis were the most common agents (44.8% and 34.5%, respectively). In seven instances the clinical picture was related to cytomegalovirus, although this diagnosis can not be easily done.
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PMID:[Evaluation of bronchoalveolar lavage in the microbiological diagnosis of pneumonia in patients at risk]. 186 7

Legionella pneumophila, the causative agent of Legionnaires' disease is able to live and multiply within macrophages as well as within protozoan organisms. Legionella strains inhibit phagosome-lysosome fusion and phagosome acidification. By using two different cell culture systems, one derived from human macrophages and the other from human embryo lung fibroblastic cells, it is demonstrated that Legionella strains lose their virulence following cultivation in the laboratory. In order to study the mechanisms involved in intracellular survival of Legionella a genomic library of strain Legionella pneumophila Philadelphia I was established in Escherichia coli K-12. By cosmid cloning technique we were able to clone five putative virulence factors, two of which exhibit hemolytic activities and three of which represent membrane-associated proteins of 19, 26 and 60 kilodalton. One of the hemolytic proteins, termed legiolysin, represents a new toxin which specifically lyses human erythrocytes. The other hemolysin exhibits proteolytic properties in addition and is cytolytic for Vero and CHO cells. Further studies will be necessary to determine the exact role of the cloned proteins in the pathogenesis of Legionella.
Infection 1991
PMID:Intracellular survival and expression of virulence determinants of Legionella pneumophila. 187 52

A prospective study of community acquired lower respiratory tract infection in the elderly was carried out over a 15-month period. During this time 127 consecutive admissions to two acute geriatric medical wards were studied. An aetiology was established in 77 (61%) of cases. Streptococcus pneumoniae was identified in 37% of patients. Haemophilus influenzae in 18% and Branhamella catarrhalis in 10%. Infection with Mycoplasma pneumoniae was found in only one episode and no cases of Legionella pneumophilia were diagnosed. A significant number of patients had multiple bacterial pathogens isolated: 18% of all bacterial pathogens isolated were ampicillin resistant. Fourteen patients died (11%). Lower respiratory tract infection is a frequent cause of hospital admission for those aged over 65 and is often regarded as a preterminal event. Adequately treated however, mortality is no higher than in the general population. Knowledge of the likely pathogens allows early and appropriate antibiotic therapy for these patients whether at home or on admission to hospital.
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PMID:Prospective hospital study of community acquired lower respiratory tract infection in the elderly. 190 44


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