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

The radiographic findings in the acute phase of Legionella pneumonia are generally non-specific and have been previously documented. A retrospective assessment of 12 patients with this bacterial pneumonia revealed that resolution of the radiographic findings was prolonged in five. The predominant feature in such patients is the transient finding of interstitial consolidation following the air-space consolidation, not unlike that of Mycoplasma or viral pneumonia. Eventual return to normal was evident in three patients and residual parenchymal fibrosis was noted in two patients.
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PMID:Radiographic analysis of the course of Legionella pneumonia. 688 81

During the 2-year period 1977 through 1979, 26 patients with Legionnaires' disease were seen at the Mayo Clinic and affiliated hospitals. The patients ranged in age from 17 to 81 years with a median of 51 years. Twelve (46%) were immunologically compromised. Most of the other patients had underlying chronic tobacco bronchitis. Hectic fever, cough, and diarrhea were common symptoms. Chest radiographs showed patchy perihilar infiltrates that often progressed to consolidation. Diagnosis was made by indirect fluorescent antibody testing in 15 patients (58%), but in no case was the test diagnostic during the first week of illness. In seven patients the diagnosis was established by positive direct flourescent antibody testing of lung tissue, in two cases by culture of lung tissue, and in one case each by direct fluorescent antibody positivity of sputum or bronchial washing. Of the 26 patients, 3 (12%) required hemodialysis for acute renal failure and 5 (19%) died. A favorable clinical response to therapy with erythromycin was noted. The differential diagnosis of Legionnaires' disease must include other bacterial pneumonias, as well as mycoplasma, psittacosis, Q fever, and viral pneumonia. For critically ill patients, open-lung biopsy may be necessary to provide a rapid diagnosis. Current evidence suggests that erythromycin alone or in combination with rifampin is the treatment of choice. A 3-week course of therapy is recommended in order to prevent relapse.
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PMID:Legionnaires' disease: a review of the epidemiology and clinical manifestations of a newly recognized infection. 735 52

Adult patients hospitalised with community-acquired pneumonia were studied prospectively to determine the microbial aetiology of pneumonia. Between April 1996 and March 1997, blood and sputum samples were collected for culture. Throat swabs were obtained for isolation of viruses and for detection of antigens of Chlamydia pneumoniae, influenza viruses A and B, respiratory syncytial virus and parainfluenza virus. Antibodies against Legionella spp., Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci, Coxiella burnetii, influenza viruses A and B, respiratory syncytial virus, adenovirus and parainfluenza virus were tested in serum samples. Two hundred eleven patients were included in the study; paired sera were available from 152 patients. Blood culture was positive in 23 (10.9%) patients, Streptococcus pneumoniae being the bacterium isolated most frequently. A fourfold or greater rise or fall in the Chlamydia pneumoniae IgG and/or IgM antibody titre was found in 20 (9.5%) patients and a high antibody titre (> or = 1:512) in the first and/or the second serum sample in 18 (18.5%) patients. Antibodies confirming acute Mycoplasma pneumoniae infection were found in 12 (5.7%) patients, Legionella spp. in six (2.8%), Chlamydia psittaci in two and Coxiella burnetii in one. Three patients had pulmonary tuberculosis. Only two patients had a virus present in the throat swab (adenovirus in one patient and echovirus in the other), and in nine patients, viral antigen was detected. Acute viral infection was confirmed in 51 (24.1%) patients. Bacterial pneumonia was diagnosed in 84 (39.8%) patients, 23 of whom had concurrent viral infection. Acute viral pneumonia without any other identified pathogen was diagnosed in 28 patients. Streptococcus pneumoniae and Chlamydia pneumoniae were the most frequently identified microorganisms.
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PMID:Microbial aetiology of community-acquired pneumonia in hospitalised patients. 1061 51

Molecular diagnostic techniques, such as polymerase chain reaction (PCR), are promising tools for the rapid etiological diagnosis of pneumonia. PCR offers potential advantages over conventional tests for the detection of Mycoplasma pneumoniae, Legionella species, and Chlamydia pneumoniae. For pneumococcal pneumonia in adults, PCR adds little to existing diagnostic tests and is unable to distinguish pneumococcal colonization from infection when testing respiratory samples. Although PCR is probably more sensitive than are conventional microscopy-based methods for diagnosing Pneumocystis carinii pneumonia, the specificity is uncertain, because P. carinii can occasionally be detected in the absence of clinical symptoms. PCR is useful for the diagnosis of viral pneumonia in immunocompromised patients. Further work is required to better characterize the role of PCR versus the role of other tests for diagnosing pneumonia and to develop standard PCR assays that can be readily adopted by routine diagnostic laboratories.
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PMID:Nucleic acid amplification tests for the diagnosis of pneumonia. 1271 12

'Atypical' lower respiratory tract pathogens often cause a distinct identifiable syndrome in adults, but in children the clinical presentation of atypical, typical and viral pneumonia is less well differentiated. Specific microbiological investigations are usually required, but an understanding of their strengths and weaknesses is necessary to make interpretation possible. This review examines clinical presentation, microbiology and current evidence surrounding diagnostic techniques for Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, Bordetella pertussis and Legionella species. Applying an understanding of the investigations to the diagnosis of pneumonia in children may lead to more appropriate patient management by ensuring that they clarify rather than further obscure the diagnosis.
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PMID:Microbiological aspects of bacterial lower respiratory tract illness in children: atypical pathogens. 1786 19

This study aims to evaluate the clinical features, diagnosis, and treatment efficacy in patients with pneumonia-associated rhabdomyolysis and acute renal failure. The subjects included six patients who had presented with rhabdomyolysis and acute renal failure due to bacterial or viral pneumonia on admission to our university hospital and the Yokohama Social Insurance Central Hospital between 2004 and 2005. The causative organisms were identified as Legionella pneumophila (N = 1), Staphylococcus epidermidis (N = 2), Staphylococcus aureus (N = 1), and Unknown (N = 2). For anuric or oliguric patients (N = 4), a blood purification therapy was performed, while conservative therapy was administered to those with a normal urine volume (N = 2). The patient suffering from L. pneumophila pneumonia did not survive, while the other patients regained full kidney function. It is important to identify, evaluate, and treat patients with bacterial or viral pneumonia-associated rhabdomyolysis and acute renal failure.
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PMID:Clinical evaluation of pneumonia-associated rhabdomyolysis with acute renal failure. 1838 68

This study aimed to determine the aetiology of community-acquired pneumonia (CAP) by adding polymerase chain reaction (PCR) to conventional methods and to describe the clinical and laboratory features between patients with bacterial pneumonia (BP) and viral pneumonia (VP). Adults with CAP admitted from November 2009 to October 2010 were included. Demographics, comorbidities, severity and clinical features were recorded. Conventional microbiological methods included blood and sputum cultures, acute and convalescent serologic samples, and antigen urinary detection. New methods included multiplex PCR for Mycoplasma pneumoniae, Legionella pneumophila, Chlamydophila pneumoniae, Bordetella pertussis and 15 respiratory viruses. A total of 169 patients were included. Using conventional methods, we identified a pathogen in 51 % of cases. With PCR, up to 70 % of cases had an aetiological diagnosis. Forty-five patients had BP (34 %), 22 had VP (17 %) and 25 (19 %) had co-infection (BP and VP). Pneumococci and respiratory syncytial virus (RSV) were the most frequently identified pathogens. Procalcitonin (PCT) and C-reactive protein (CRP) median values were significantly higher in BP than in VP patients. Shaking chills, higher CURB score and shock were significantly more frequent in BP. A viral infection was identified in more than one-third of patients with CAP. Clinical and laboratory features could help to differentiate between VP and BP and to guide empirical therapy.
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PMID:Aetiology of community-acquired pneumonia among adults in an H1N1 pandemic year: the role of respiratory viruses. 2254 30

The term atypical pneumonia was first used in 1938, and by the 1970s it was widely used to refer to pneumonia due to Mycoplasma pneumoniae, Legionella pneumophila (or other Legionella species), and Chlamydophila pneumoniae. However, in the purest sense all pneumonias other than the classic bacterial pneumonias are atypical. Currently many favor abolition of the term atypical pneumonia.This review categorizes atypical pneumonia pathogens as conventional ones; viral agents and emerging atypical pneumonia pathogens. We emphasize viral pneumonia because with the increasing availability of multiplex polymerase chain reaction we can identify the agent(s) responsible for viral pneumonia. By using a sensitive assay for procalcitonin one can distinguish between viral and bacterial pneumonia. This allows pneumonia to be categorized as bacterial or viral at the time of admission to hospital or at discharge from the emergency department and soon thereafter further classified as to the etiology, which should be stated as definite or probable.
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PMID:The role of atypical pathogens in community-acquired pneumonia. 2271 10

A middle-aged immunocompetent woman was diagnosed and treated for a severe pulmonary human herpesvirus 3 infection. During the treatment, an infection from Legionella pneumophila serogroup 1 was also diagnosed. This coinfection threatened the life of the patient and led to serious permanent sequelae. This report highlights the importance of preventing Legionella environmental contamination, suspecting Legionella coinfection in patients with viral pneumonia, and vaccinating susceptible adults against chickenpox.
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PMID:Legionnaires' disease contracted from patient workplace: First report of a severe case of coinfection with varicella-zoster virus. 2731 15