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

The possibility of indigenous Legionnaires' disease should be known as suggested by the following case : a 69-year-old man, diabetic, having never travelled out of Poitou, suffers from serious pneumonia with dyspnea needing mechanical ventilation with positive end-expiratory pressure. After failure of ampicillin, the evolution seems favourable with cotrimoxazole. However the discontinuation of this last drug is followed by a relapse which is treated with success by erythromycin. Serodiagnoses will be positive for Legionella Pneumophila serogroup I. This case, typical by its clinical features, makes itself noticed by its epidemiology and the relapse under cotrimoxazole, proving that erythromycin remains the choice antibiotic for these infections.
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PMID:[Acute respiratory distress syndrome: indigenous Legionnaires' disease (author's transl)]. 626 96

A 2 8/12-year-old boy showed an unusual course of a Legionella pneumophila infection with severe dyspnea, longterm loss of conscience (5 days) and permanent persistence of pulmonary obstruction.
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PMID:Unusual progression of a Legionella pneumophila infection in a young child. 669 64

A "new pneumonia" is named legionnaires' disease after a gramnegative bacillus - Legionella pneumophila, unknown until 1977. Sofar it has been observed mostly in older male patients, rarely in children and never before in Germany. The legionnaires' disease in our patient, a five and half years old boy with cystic fibrosis caused a severe dyspnea and multilobular pulmonary densifications on the chest X-ray film. The diagnosis was verified by the rise of the titer in the indirect immune fluorescence test and the success of the therapy with erythromycin.
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PMID:[Legionnaires' disease in cystic fibrosis]. 674 54

Legionnaires disease, which is commonly manifested as pneumonia, was only recently recognized to be a bacterial infection. Diagnosis can be difficult because Gram's stain does not readily stain the bacterium in pulmonary secretions, the organism is not readily cultured, and legionellae is not affected by many commonly used antibiotics. In a retrospective review of all of our transplant patients, we identified 14 cases of Legionnaires' disease after 101 renal transplants. The patients characteristically had high fever, polymorphonuclear leukocytosis, dyspnea and an unproductive cough accompanied by radiographic changes of consolidating pneumonia. Legionnaires' disease can be diagnosed by direct immunofluorescent antibody staining, culture on special media or increases in serum titers of legionella antibodies in surviving patients. Since the recognition of Legionnaires' disease in 1977, we have successfully treated seven renal transplant patients using erythromycin with or without rifampin.
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PMID:Legionnaires' disease in renal transplant patients. 701 9

In 1978 and 1979, eight sporadic cases of Legionella pneumonia were observed in the Berne and Ticino areas of Switzerland. In all cases the diagnosis was established serologically using indirect immunofluorescence. Seroconversion was observed in five patients. In three cases initially high antibody titers decreased progressively. The clinical picture was characterized by acute onset with high fever, frequent chills, and dry cough. Occasional concomitant symptoms included muscular pains, headache, thoracic pain, dyspnea, hemoptysis, and gastrointestinal and central nervous symptoms. Laboratory findings showed markedly increased BSR as well as slightly increased WBC with a pronounced shift to the left. In all cases, X-ray examinations demonstrated extended, mainly unilateral and often remarkedly peripheral infiltrations of the lung. On the basis of the clinical course, two groups could be distinguished: (a) non-complicated cases of pneumonia with rapid improvement within 2-3 weeks; and (b) cases with a protracted sometimes severe course with persistence of the infiltrations up to 4 months and more. All patients with a protracted course suffered from concomitant symptoms. Whereas none of the patients died of legionellosis, two patients died six months later from their underlying disease. Most patients were treated with several antibiotics. In three patients definite improvement occurred only after therapy had been changed to doxycycline. Erythromycin, currently recommended as the drug of choice, was used in none of these cases.
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PMID:[Clinical data on Legionnaires' disease. Report on 8 sporadic cases of Legionella pneumonia]. 720 64

Experiments were carried out to determine the infectivity, clinical course of disease, and lethality of aerosols of Legionella pneumophila for guinea pigs. The median infectious dose was less than 129 organisms; the 50% lethal dose was 1.4 x 10(5) organisms. In addition, the intraperitoneal 50% lethal dose was 3.0 x 10(6) cells, a value indicating that the organisms were less virulent by the intraperitoneal route than by aerosol. Nonfatal disease always included fever and weight loss. These signs were accompanied by sporadic bacteremia and dyspnea. Leukocyte counts were uninformative. In general, the severity of fever and extent of serologic (microagglutination titer) response were dose-related. The guinea pig may be used as a model for Legionnaires' disease, but the only dependable clinical criteria of infection after airborne challenge are weight loss, fever, and seroconversion.
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PMID:Dose-response of guinea pigs experimentally infected with aerosols of Legionella pneumophila. 736 75

Pleural effusion caused by Legionella is seen fairly frequently but is hardly ever of great clinical significance. Pericardial involvement has been described only rarely. We present a case of pleuropericarditis as the only sign of infection by Legionella pneumophila in a 66-years-old man with no prior history of disease. The patient came to the hospital with chest pain suggestive of pleurisy, low-grade fever, dry cough and dyspnea. The etiology was not suspected and the diagnosis was made retrospectively based on indirect immunofluorescence. After 3 weeks of treatment with high dose of erythromycin the patient recovered and remains asymptomatic to date. We conclude that infection by Legionella pneumophila should be suspected in patients with pleurisy or pericarditis of unknown cause.
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PMID:[Pleuropericarditis as the only manifestation of Legionella pneumophila infection]. 778 88

A 63-year-old man with dyspnea and high fever was admitted to the hospital. A pneumonic shadow in the right lower lung field was observed. After administration of rifampicin and clarithromycin, his symptoms were gradually alleviated. Although Legionella pneumonia was highly suspected, Legionella pneumophila was not isolated from his sputum specimens and the serum level of indirect immunofluorescent antibody titer was not significantly elevated. However, we believe it is very likely that he had Legionella pneumonia, because we detected a high density of urinary Legionella pneumophila serogroup 1 antigen by antigen capture EIA.
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PMID:[Legionella pneumonia diagnosed by urinary antigen detection]. 779 Dec 79

A fatal pneumonia due to Legionella pneumophila was diagnosed in a young calf reared in a dairy herd located in northern Italy. Clinical symptoms consisted of watery diarrhea, hyperthermia, anorexia, and severe dyspnea. The pathological and histological findings were very similar to those observed in human legionellosis. Legionella pneumophila serogroup 1 (SG1) and SG10 were isolated from the calfs lung, and L. pneumophila SG1 was isolated from the calfs liver. L. pneumophila SG1 was also demonstrated in the lung tissue by immunofluorescence and immunohistochemical examinations. Nine of 10 L. pneumophila SG1 isolates belonged to the Olda subtype, and 1 belonged to the Camperdown subtype. A very low prevalence of antibodies to Legionella was detected in cows and calves reared in the same herd. Cultures of aqueous sediment of an old electric water heater which supplied hot water for the feeding of the calves yielded L. pneumophila SG1. Four of the colonies tested belonged to the Olda subtype. Ten clinical and four environmental isolates were examined for the presence of plasmids. Nine of them were also examined by pulsed-field gel electrophoresis assay, and the same patterns were found for L. pneumophila SG1 Olda strains isolated from the calf and from the electric heater. This is the first report of a documented case of a naturally occurring Legionella pneumonia in an animal. Cattle probably act as accidental hosts for legionellae, much the same as humans.
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PMID:Epidemiological and environmental investigations of Legionella pneumophila infection in cattle and case report of fatal pneumonia in a calf. 965 Sep 41

A 52-year-old male gardener, who traveled to Guam Island several days ago, was admitted to our hospital with fever, cough and dyspnea. His chest X-ray showed bilateral infiltration and he was severely hypoxic and hypotensive on admission. He died of multiple organ failure in spite of intensive treatment with mechanical ventilation antibiotics including erythromycin. Legionella longbeachae serotype 1 was isolated from his sputum and was regarded as the etiologic agent. Legionella longbeachae was not isolated from the same type of leaf mold that he used as potting soil. This is the first case of Legionella longbeachae pneumonia from whom the organism was isolated in Japan.
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PMID:[Legionella longbeachae pneumonia in a gardener]. 984 27


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