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)

Waters in marine and freshwater areas of Puerto Rico were analyzed for the presence of Legionella spp. by direct fluorescent antibody assay with guinea pig confirmation. Several species, including L. bozemanii, L. dumoffii, L. gormanii, L. longbeachae, L. micdadei, and L. pneumophila, were widely distributed among all sites. Legionellaceae, including L. pneumophila, were found in high densities in water collected in the rain forest from epiphytes in trees 30 ft. (about 9.25 m) above the ground. Both interspecific and intersite variations were significant. L. pneumophila was the most abundant species at all sites, with average densities of 10(4) cells ml-1, very close to the range which is potentially pathogenic for humans. Densities of L. pneumophila were highest in sewage-contaminated coastal waters. These are the highest densities of Legionella spp. ever reported for marine habitats. Densities of L. pneumophila were positively correlated with concentrations of sulfates, phosphates, and pH. A survey of 88 fatal atypical pneumonia cases at a Puerto Rico hospital showed that 15% of the patients had L. pneumophila infections. This study establishes L. pneumophila as a relatively common cause of atypical pneumonia in Puerto Rico and suggests natural aquatic habitats as possible sources or reservoirs of pathogenic Legionella spp. in the tropics.
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PMID:Abundance and distribution of Legionellaceae in Puerto Rican waters. 331 10

Legionnaires' disease is an illness with protean manifestations that are due to infection with Legionella pneumophila. It occurs both in epidemic and sporadic form and usually presents as an atypical pneumonia. Relative bradycardia, abnormal liver function test results, and a patient presenting with an atypical pneumonia should alert the clinician to the possibility of Legionella. The presence of systemic involvement, specifically neurological, gastrointestinal, and renal abnormalities, should further suggest the diagnosis. Patients may demonstrate multiple extrapulmonary manifestations of legionnaires' disease, sometimes without pneumonia. Several methods are available to aid the clinician in making the diagnosis of legionnaires' disease, and the use of all tests will increase the overall sensitivity.
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PMID:Clinical and laboratory aspects of Legionnaire's disease. 332 92

While the term "atypical pneumonia" has been in use for many years, it cannot in fact be defined. However, there is a persuasive reason to retain the clinical use of the term, and that is to provide a guide for the clinician in the choice of empirical antibiotic therapy for patients with acute pneumonia. Atypical pneumonia, then, is a descriptive term for a common clinical syndrome. Provided certain clinicoepidemiological groups are excluded, the most common infectious causes of this syndrome are Mycoplasma pneumoniae, Chlamydia psittaci, Coxiella burneti, and Legionella species, but it should be stressed that the syndrome may occasionally be produced by other infectious and non-infectious diseases. Conversely, the atypical pneumonia syndrome occupies only one part of the clinical spectrum of disease that is caused by these organisms. This becomes important when one is selecting antibiotic therapy for patients with other respiratory syndromes, especially those with life-threatening disease. The antimicrobial therapy of the three common causes of atypical pneumonia is discussed in detail.
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PMID:Atypical pneumonia: recognition and treatment. 360 Apr 71

A diabetic patient presented with symptoms and laboratory findings compatible with atypical pneumonia. Despite appropriate antibiotic therapy, his dyspnea, arterial oxygenation, and chest roentgenographic findings worsened. Because the patient had a history of homosexual contact, an open lung biopsy was obtained to morphologically define the tissue reaction and to search for a specific etiology. Histologic examination showed bronchiolitis obliterans but did not demonstrate a cause. Legionnaires' disease was subsequently diagnosed on the basis of a fourfold rise in indirect fluorescent antibody titer. This case report demonstrates that Legionella pneumophila may induce lung injury with bronchiolitis obliterans. Such patients may benefit from corticosteroid treatment.
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PMID:Bronchiolitis obliterans caused by Legionella pneumophila. 399 79

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

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

An indirect fluorescent antibody (IFA) technique was developed to detect IgG and IgM-specific antibodies to Mycoplasma pneumoniae. The presence of IgM-specific mycoplasma antibody was interpreted as reflecting active infection in patients with atypical pneumonia or other clinically compatible illness. The procedure is suitable for use in routine clinical laboratories, correlated well with complement fixation test results and did not show cross reaction with Legionella pneumophila antibody. The ready availability of an acute-phase procedure for diagnosis of Mycoplasma pneumoniae infection permits therapeutic judgments based on testing of the acute serum sample.
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PMID:Acute-phase, indirect fluorescent antibody procedure for diagnosis of Mycoplasma pneumoniae infection. 634 45

The genus Legionella, belonging to the family of Legionellaceae, comprises nowadays seven species, among which Legionella pneumophila might be the most important. The identification of the agent is difficult because L. pneumophila is very pretentious requiring peculiar conditions concerning culture medium, temperature, and time. The initial cultivation will succeed the best in an atmosphere enriched with CO2. The demonstration of serum antibodies will succeed by means of indirect immunofluorescence; recently the micro-agglutination test is vastly applied. The clinical picture of Legionellosis is characterized by an atypical pneumonia with a serious course in most cases. The Pontiac Fever is an illness with milder course than the classical form of Legionellosis. Erythromycin and Rifampicin are the chemotherapeutics of choice.
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PMID:[The detection of the agent of Legionnaires' disease--a confirmation of Koch's postulates]. 635 47

Out of 1961 patients with the clinical diagnosis of atypical pneumonia 11 cases (0.65%) of recent Legionella infections were diagnosed by indirect immunofluorescence test (IFA). A higher incidence (1.37%) has been found in 364 patients in whom clinicians suspected a Legionella infection and therefore asked for serological testing. Prevalence of antibodies (greater than or equal to 1:32) reacting with antigens of L. pneumophila serogroup 1 to 6 was highest to serogroup 6 (37%), and lowest to serogroup 1 (4.3%). Specificity of IFA for reciprocal titer of 128 to L. pneumophila serogroup 1 was calculated with 99.5%, for serogroup 6 with only 87.7%. Morbidity of severe Legionella pneumonias in Austria can be estimated at about 1.5 cases per 100 000 inhabitants.
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PMID:Sero-epidemiology of legionellosis in Austria. 635 9

Sera of 30 patients with atypical pneumonia were tested for antibodies against the representative strains of Legionella pneumophila 1-6 serogroups and 4 species of legionella-like organisms. Investigations were carried out with indirect immunofluorescence assay. The sera of 2 patients gave a titre of 2048 and 1024 with serogroup 5 and 4, respectively. The high antilegionella IgM titres were indicative of recent infections. Legionellae were not detected in transtracheal aspirate and in autopsy material.
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PMID:Diagnostic experience in two cases of legionellosis. 643 15


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