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

A number of radiologic features on chest X-ray may aid in diagnosis and management of the patient with legionella infection. The infiltrates in legionnaires' disease frequently progress despite initiation of appropriate antibiotic therapy. Pleural effusion is common and occasionally seen even in the absence of lung field infiltrates. Pleural-based infiltrates associated with pleuritic pain may mimic pulmonary embolism. Circumscribed peripheral densities are commonly seen in immunosuppressed patients. Cavitation is also a prominent feature in this patient group and may develop during clinical improvement. Radiographic severity does not correlate with clinical outcome. Resolution of infiltrates may be slow, and the tendency for delayed clearing should be considered before initiating further invasive diagnostic investigation. Infections due to Tatlockia (Legionella) micdadei and Legionella bozemanii are more commonly reported in immunocompromised hosts; the radiographic manifestations are similar to those seen in Legionella pneumophila infection in the immunosuppressed.
Semin Respir Infect 1987 Dec
PMID:The radiologic manifestations of Legionella pneumonia. 332 94

Members of the family Legionellaceae have emerged as important nosocomial pathogens. Bronchopneumonia is the typical illness and mimics other nosocomial pneumonias. On rare occasion, surgical wound infections may be due to legionellae. Legionella pneumophila is the species causing most human illness, but other species may predominate in individual institutions. Pneumonia is acquired by inhalation of environmental aerosols from water sources contaminated by Legionella sp. In the hospital setting contaminated water sources include potable water, heat-exchange systems, and cooling towers. Water temperature control and maintenance programs may prevent colonization of water systems. Should clinical cases and water colonization occur, aggressive suppression/eradication programs--by chlorination or heat/flush--must be instituted. Surveillance of pneumonias in high-risk patient groups is essential for early detection of a nosocomial outbreak. There has been no evidence of person-to-person transmission. Familiarity with diagnostic techniques and their pitfalls will permit institution of effective antimicrobial therapy.
Semin Respir Infect 1987 Dec
PMID:Nosocomial Legionnaires' disease. 332 95

Of the Legionellaceae family, Pittsburgh pneumonia agent (Tatlockia micdadei, Legionella micdadei) is second only to Legionella pneumophila in causing human pneumonia. In nosocomial infection, the patients tend to be immunosuppressed. The clinical presentation is nonspecific, although in immunosuppressed hosts the presentation may mimic that of pulmonary embolus (pleuritic chest pain, nonproductive cough, pleural-based densities on chest rontgenogram). The reservoir for the organism is water, and prevention of nosocomial infections can be accomplished by disinfection of the water supply. Diagnosis is best established by isolation of the organism from respiratory secretions by using selective, dye-containing buffered charcoal-yeast extract agar. The organisms can be acid-fast when clinical specimens are stained. Erythromycin is the antibiotic of choice, although tetracyclines, trimethoprim-sulfamethoxazole, and rifampin have also proved to be efficacious.
Semin Respir Infect 1987 Dec
PMID:Infections caused by the Pittsburgh pneumonia agent. 332 96

The family Legionellaceae contains the new genus and species Legionella pneumophila; organisms that resemble L pneumophila but differ in one or more phenotypes are called legionella-like organisms and constitute a growing list of new species now numbering over two dozen, and the characterization of additional species of legionellae continues to expand. Similar to L pneumophila, some of these new species have additional serogroups within the species. These new species have varying degrees of clinical and epidemiological importance. We will review historical, laboratory, and clinical aspects of Legionella species other than L pneumophila and L micdadei.
Semin Respir Infect 1987 Dec
PMID:Legionella-like organisms. 332 97

Selection of therapy for legionella infections originated with the clinical observation after the 1976 Philadelphia outbreak that patients treated with erythromycin or tetracycline did better than those who received cephalosporins or aminoglycosides. Early in vitro antibiotic susceptibility studies suggested that rifampin and erythromycin were both active against Legionella pneumophila. However, subsequent in vitro susceptibility studies to other antibiotics have produced variable results, depending on the medium and methodology used. Antibiotic studies within polymorphonuclear leukocytes and alveolar macrophages indicate that those actively concentrated within these cells are predictive of successful therapy. These include erythromycin, rifampin, and certain quinolones. On the other hand, beta-lactam antibiotics such as penicillin, cefoxitin, and imipenem are less likely to be successful because of their lack of concentration within phagocytes. These observations have been confirmed in animal model studies where erythromycin, rifampin, and quinolones have demonstrated efficacy. The addition of rifampin to erythromycin or to doxycycline may be more effective than therapeutic results with either antibiotic alone. Although erythromycin is presently the treatment of choice for legionellosis, the addition of rifampin is recommended, particularly in immunocompromised patients. Doxycycline has served as an appropriate alternative agent, the newer quinolones may be useful and are deserving of carefully designed clinical trials.
Semin Respir Infect 1987 Dec
PMID:Therapeutic considerations in the treatment of Legionella infections. 332 98

During a one year period acute pericarditis was diagnosed in 16 consecutive patients without acute infarction or malignancy. In two of these patients with both pericarditis and pneumonia Legionella infection was present. One case was caused by Legionella longbeachae and the other by both Legionella longbeachae and Legionella jordanis. When pericarditis is associated with pneumonia Legionella infection should be sought so that effective treatment with erythromycin may be started early.
Br Heart J 1987 Dec
PMID:Combined pericarditis and pneumonia caused by Legionella infection. 342 2

The susceptibility of a strain of Legionella pneumophila to disinfection by an organic halamine, free chlorine, and a mixture of the organic halamine and free chlorine was assessed. The organic halamine was found to have superior stability in solution and to exhibit adequate disinfectant potential over a period of 1 month of repeated reinoculations of fresh bacteria. The combined halamine exhibited great potential for use in maintaining closed-cycle cooling water systems free of L. pneumophila.
Appl Environ Microbiol 1987 Dec
PMID:Inactivation of Legionella pneumophila by hypochlorite and an organic chloramine. 343 50

Five cases of Legionnaires' disease caused by Legionella dumoffii were identified within an 11-month period in a hospital in the Quebec City area. In four cases bacterial isolates were obtained from clinical specimens, and in one case seroconversion was demonstrated. All the patients had been admitted to hospital within 10 days before diagnosis. Two of the patients were immunosuppressed children. Only 1 of the 40 hot water samples from the hospital yielded L. dumoffii; however, 6 of 11 distilled water samples contained the bacterium. All the patients had been exposed to distilled water, four through respiratory therapy equipment and one through a room humidifier. Following the use of sterile distilled water in the apparatus, no further cases were identified. This is the first reported outbreak of Legionnaires' disease caused by L. dumoffii, and it is the first time that nosocomial legionellosis has been linked to contaminated distilled water in Canada.
CMAJ 1986 Dec 01
PMID:Legionnaires' disease caused by Legionella dumoffii in distilled water. 353 52

The bacteriological investigation of an outbreak of Legionnaires' disease in Glasgow Royal Infirmary affecting 16 patients is described. Most of the patients had been treated in high-dependency areas on two floors of the hospital supplied by the same two air-conditioned ventilation systems. The source of infection was traced to contamination of a cooling tower from which a plume of spray discharged into the intake vents of the two ventilation systems. Rubber grommets within the cooling tower probably provided a nidus of infection there. The control and management of the outbreak are discussed: a policy of frankness about the course and progress of the investigations was adopted and helped to allay anxiety on the part of both staff and media.
J Hyg (Lond) 1986 Dec
PMID:Outbreak of Legionnaires' disease in Glasgow Royal Infirmary: microbiological aspects. 354 Jan 9

Twelve samples of water taken from the cooling tower of UOEH were examined for the presence of microorganisms belonging to the genus Legionella by using a new selective medium, Wadowsky-Yee-Okuda (WYO) medium. Three samples contained this organism and they were identified as Legionella pneumophila from their biochemical properties. Among the three contaminated samples, two yielded L. pneumophila serogroup 1 and 3, and the other contained only L. pneumophila serogroup 1. One of the samples of the contaminated cooling tower water was treated with sodium hypochlorite as a disinfectant, indicating that this agent is probably not effective in eliminating L. pneumophila from cooling tower water at that concentration. An effective method of disinfection for Legionella spp. in the cooling tower must be developed to prevent infection in the hospital.
J UOEH 1986 Dec 01
PMID:[Isolation of Legionella pneumophila from the UOEH cooling tower]. 380 18


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