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

Cigarette smoking exerts deleterious effects not only on the respiratory tract, but also on the lung's parenchyma. The FEV is reduced in heavy chronic smokers. Persistent smoking has an unfavourable influence on mucociliary activity. According to the results of recent research almost 8 million people in the U.S. were suffering from chronic bronchitis in 1981. There is a direct correlation between the number of cigarettes smoked, over what period of time, and the incidence of chronic bronchitis. In studies with patients suffering from exacerbations of chronic bronchitis the most common bacterial pathogens found were Haemophilus influenzae, Streptococcus pneumoniae and Branhamella catarrhalis. Mycoplasma pneumoniae and certain viruses are counted amongst the non-bacterial pathogens. Antibiotics should be effective against such possible pathogens. The resistance of H. influenzae to ampicillin/amoxicillin is currently observed in at least 12% of cases, whilst H. influenzae is regularly observed to be resistant to erythromycin. Cefaclor, trimethoprim/sulphamethoxazole and amoxicillin/clavulanic acid offer satisfactory forms of treatment. Pneumonia caused by S. pneumoniae, H. influenzae, B. catarrhalis and Legionella pneumophila is often seen in smokers and patients with COLD. Haemocultures should be prepared for all hospitalized patients. Penicillin G and/or V is the agent of choice. Cefaclor or trimethoprim/sulphamethoxazole can be given to counter beta-lactamase producing H. influenzae whilst cefaclor, erythromycin, tetracycline or trimethoprim/sulphamethoxazole are used for the treatment of B. catarrhalis infections. In Legionella infections erythromycin is the preferred treatment. A combination of erythromycin and cefamandole or ceftriaxone is indicated for empirical management. Patients with COLD should be immunised with pneumococcus and influenza vaccines.
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PMID:[Smoking and lower respiratory tract infection]. 361 Mar 32

An enzyme-linked immunosorbent assay (ELISA) with a highly purified pneumolysin as the antigen was evaluated for serological diagnosis of pneumococcal pneumonia. One hundred four healthy controls were tested, and the specificity of the test was set to 95%. In samples from patients with bacteremic pneumococcal pneumonia, 82% (18 of 22) were positive, i.e., at least one serum sample had a titer above the upper normal limit or at least a twofold rise in antibody titers was noted. In nonbacteremic pneumococcal pneumonia, 45% (21 of 47) of samples were positive. All sera were negative for patients with pneumonia caused by Haemophilus influenzae, Legionella pneumophila, Chlamydia psittaci, and influenza A virus. However, in patients with a diagnosis of Mycoplasma pneumoniae infection, 8 of 25 (32%) samples were positive for antibodies to pneumolysin. All sera, including those from patients with mycoplasma infection, were negative to a protein control antigen by ELISA. Serum immunoglobulin G response to pneumolysin as measured by ELISA might thus be an aid in the laboratory diagnosis of pneumococcal pneumonia. This assay may also help to further elucidate the occurrence of dual infections with pneumococci.
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PMID:Diagnosis of pneumococcal pneumonia by enzyme-linked immunosorbent assay of antibodies to pneumococcal hemolysin (pneumolysin). 381 19

A 1949 outbreak of flu-like illness in steam-turbine condenser cleaners was investigated in 1979. Clinical and epidemiologic features matched those in previously described outbreaks of nonpneumonic legionellosis (Pontiac fever). Titers by indirect immunofluorescence using polyvalent Legionella pneumophila antigen were significantly higher for late convalescent-phase serum samples from condenser workers than for control serum samples submitted to the Centers for Disease Control. Three workers who had cleaned the condensers on several occasions had experienced recurrent illness associated with these operations, which might support the theory that nonpneumonic legionellosis is caused by an immune reaction to an inhaled antigen or bacterial toxin of L. pneumophila, rather than a true infection.
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PMID:A 1949 outbreak of Pontiac fever-like illness in steam condenser cleaners. 388 24

Influenza virus administered intranasally to AKR/J mice, followed 3 days later by Legionella pneumophila inoculated intranasally, caused significantly greater mortality than did either of the two agents administered alone. Viable concentrations of both bacteria and viruses dropped in sequentially infected animals, despite the ultimate fatal outcome. Viral concentrations, however, did not decrease as rapidly in sequentially infected as in singly infected mice. Histopathologic lesions were consistent with viral replication aided by elaboration of a bacterial toxin. This observation contrasts with the more commonly observed sequence in which the bacterium proliferates after the virus interferes with host defense. Cell-free preparations were found to have toxic activity.
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PMID:Effect of prior influenza virus infections on susceptibility of AKR/J mice to respiratory challenge with Legionella pneumophila. 396 61

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

The etiology of community-acquired pneumonia was studied in 127 patients with roentgenologically verified pneumonia who needed hospitalization. Etiology was determined on the basis of a positive blood culture and/or a significant antibody titer increase. Streptococcus pneumoniae was the probable etiological agent in 69 patients, nontypeable Haemophilus influenzae in five patients, Streptococcus pyogenes in two patients, and Legionella pneumophila and Staphylococcus aureus in one patient each. Evidence of Mycoplasma pneumoniae infection was found in 18 patients and of Chlamydia psittaci infection in three patients. Influenza virus type A was the cause of infection in 15 patients. One patient had infection with influenza virus type B, one patient with parainfluenza virus type 1, and three patients with respiratory syncytial virus. In 20 patients there was evidence of infection with more than one microorganism. No etiological agent was found in 27 patients. Since Streptococcus pneumoniae was the predominant etiological agent penicillin should be drug of first choice in patients with pneumonia who need treatment in hospital. In young adults, however, the high frequency of Mycoplasma pneumoniae infection would justify the use of erythromycin or doxycycline as drug of first choice.
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PMID:Etiology of community-acquired pneumonia in patients requiring hospitalization. 401 66

In a protocol study of cases of atypical pneumonia over a 1-year period an etiologic agent was established in 16 cases: Legionella pneumophila in 8, Coxiella burnetii in 3, Chlamydia trachomatis in 2, Mycoplasma pneumoniae in 1, para-influenza 3 virus in 1 and cytomegalovirus in 1. In the remaining 11 cases no agent was identified; the illnesses in these cases tended to be less severe. The pneumonia took much longer to resolve in the patients with Legionnaires' disease than in all the other patients (mean interval from onset of symptoms to clearing of the chest roentgenogram: 69 days v. an average of 16 days). However, the length of stay in hospital was similar for the three groups: those with Legionnaires' disease, those with atypical pneumonia of unknown cause and those with atypical pneumonia of various other established causes. L. pneumophila infection may explain a proportion of atypical pneumonias that previously could not be diagnosed, although in this series the cause of 41% of the pneumonias remained unexplained.
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PMID:Causes of atypical pneumonia: results of a 1-year prospective study. 627 75

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

Titre levels against Legionella pneumophila, serotype 1-4, and against Legionella micdadei were measured in 2290 sera. About 1% contained specific antibodies indicating previous contact with the causative organisms within a year, suggesting a high incidence. On the other hand, the contagion index at 10% was relatively low. It relates to mild influenza-like and severe pneumonitic forms of the infection. In the Federal Republic of Germany it is likely that there are 6000-7000 cases of Legionella-caused pneumonia annually. With a death-rate of 15-20% there are thus likely to be between 1000 and 1500 deaths annually. This makes Legionnaire's disease the second most frequent cause of pneumonia.
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PMID:[Incidence of Legionnaires' disease]. 661 6

Serum samples from patients with documented influenza A virus infections were examined for antibodies to Legionella pneumophila and Mycoplasma pneumoniae to determine whether simultaneous or sequential infections with L. pneumophila and M. pneumoniae were complicating factors in influenza. When the frequency of copositivity of sera to influenza A virus and L. pneumophila was compared with the expected frequency for each infection alone, the difference was not statistically significant. However, when the frequency of copositivity of sera to influenza A virus and M. pneumoniae was compared with the expected frequency for each infection alone, there was a statistically significant (P less than 0.005) absence of coincident titers. Seasonal variations and differences in relative age frequencies for the two infections may partially explain the absence of coinfections. These data also suggest that in patients with either M. pneumoniae or influenza A virus infection, some type of protective mechanism which prevents coinfections with these organisms is present.
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PMID:Coinfections of Mycoplasma pneumoniae and Legionella pneumophila with influenza A virus. 682 98


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