Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The first case of Legionnaires' disease recognized in Pennsylvania since the Philadelphia epidemic of 1976 was that of a 53-year-old emphysematous man who had extensive unilateral pneumonia accompanied by high fever, hypoxemia, and disorientation. His illness progressed despite treatment with cephalothin, but he recovered coincident with the administration of gentamicin and erythromycin. The diagnosis was established serologically by a 32-fold rise in antibody titer to the agent of Legionnaires' disease. Similar illness did not affect others in his community, and infection in four family members was excluded clinically and serologically.
 ...
PMID:Sporadic Legionnaires' disease. 34 Jul 16

An analysis of seven sporadic cases of Legionnaires' disease confirmed clinical features recorded during epidemics and identified aspects of the illness either unreported or not emphasized. Four patients had central nervous system abnormalities. Mental status changes included somnolence, obtundation, delirium, disorientation, and confusion. Three patients experienced visual hallucinations, and one patient without pneumonia had a grand mal seizure with residual memory deficit. Two patients had disseminated intravascular coagulation with thrombocytopenia, elevated split fibrin products, and prolonged partial thromboplastin and prothrombin times. Four patients had severe hypoxia; one patient had an exudative pleuritis. One patient whose treatment included erythromycin had radiologic improvement of his pneumonia despite deteriorating ventilatory function that led to death. The concept of Legionnaires' disease as a severe, diagnostically perplexing pneumonic illness is valid but too narrow. The emerging spectrum is that of a multisystem disease that, besides the lungs, often involves the central nervous system and can be accompanied by disseminated intravascular coagulation.
 ...
PMID:Sporadic cases of Legionnaires' disease: the expanding clinical spectrum. 43 28

Legionella is a frequent etiologic agent in the development of both nosocomial and community acquired pneumonias. Involvement of the nervous system is common in Legionella infections. We present a case of Legionnaires' disease which illustrates distinctive neurologic findings including delirium and cerebellar dysfunction. Furthermore, this paper reviews the neurological and psychiatric features of 609 Legionella infected patients with involvement of the nervous system. The most common signs were disorientation (58%), headache (52.4%), and somnolence (39.7%). Less frequent or rare were: cerebellar dysfunction (11.2%), hallucinations (8.4%), agitation or stupor (4.1%), affective disorders (3.1%), peripheral neuropathy (2.8%), pyramidal disturbances (2.1%), memory loss (1.6%), seizures (1.5%), cranial nerve palsies (1.5%), incontinence (0.7%), and extrapyramidal disturbances (0.3%). Cranial CT scans, cerebrospinal fluid findings, and nerve and muscle biopsies were usually unremarkable. Neuropathologic examinations failed to demonstrate specific characteristics. Hyponatremia and serum CPK level elevation were present in up to 89% and 50% of patients, respectively. Prognosis of disturbances of the nervous system was mainly good. We conclude that in the presence of definite neurological findings, pulmonary infection, hyponatremia, and CPK elevation Legionella infection should be considered.
 ...
PMID:[Neurologic and psychiatric symptoms of legionella infection. Case report and overview of the clinical spectrum]. 927 65

We assessed clinical, laboratory and radiologic findings in 25 patients (21 men and 4 women; mean age 60.1 years) with Legionella pneumonia. The diagnosis was confirmed from the isolation of Legionella pneumophila in respiratory samples(nine cases), or by a fourfold increase or decrease in antibody titers in the paired serum samples (16 cases). Twelve patients were smokers, 5 patients were chronic alcoholics and 18 patients had underlying diseases. Regarding severity, the illnesses were mild (three patients), moderate (seven patients) and severe (fifteen patients). The following presenting symptoms and findings that characterize Legionella pneumonia were seen: a temperature of more than 40 degrees C (six patients), disorientation or gate disturbances(ten patients), diarrhea (eight patients), relative bradycardia(eight patients), hyponatremia(five patients), and a high creatinine phosphokinase suggesting rhabdomyolysis(five patients). Rapid progression of infiltrates on chest radiographs before appropriate antibiotic therapy was observed in seven of the twelve patients whose previous chest films were available. Only one patient, who was in endotoxin shock on admission, died. Suspected sources of infection for 13 patients were a hot spring and a public bath. We conclude that a detailed analysis of the above clinical features makes possible the diagnosis of Legionella pneumonia.
 ...
PMID:[Legionella pneumonia: report of 25 community-acquired cases]. 1264 8

A 59-year-old man was admitted for further investigation of headache. Neurological examination revealed memory loss, disorientation, and bilateral intention tremor. Legionella pneumophila antigen was detected in the urine. Brain magnetic resonance diffusion-weighted images showed marked hyperintensity in the splenium of the corpus callosum without other abnormalities. Single photon emission CT with Tc-99m hexamethyl-propyleneamine oxime showed multi-focal hypoperfusion in the brain, involving mainly the cerebellum and frontal lobe. This is the first report demonstrating cerebellar and frontal lobe hypoperfusion without corresponding MRI abnormalities in a patient with central nervous system Legionnaires' disease.
 ...
PMID:Legionnaires' disease with hypoperfusion in the cerebellum and frontal lobe on single photon emission computed tomography. 1859 53