LEGIONNAIRES DISEASE Introduction & Definition

Legionnaires' disease is a worldwide lung infection, named after an outbreak of pneumonia that took place during a legionnaires' convention. Legionnaires' disease is a common cause of community-acquired pneumonia (CAP) and some outbreaks of hospital-acquired pneumonia (HAP) (Roig, Carreres, & Domingo, 1993). This research paper will present the etiology, pathogenesis, clinical manifestations, diagnosis, and treatment of legionnaires' disease.

Legionella pneumophila was identified as the causative agent of the outbreak of pneumonia during the legionnaires' convention. Aside from L. pneumophila, a number of newly identified species of Legionella have been identified. At least 34 Legionella species and 52 serogroups have been characterized. Clinical samples show that L. pneumophila serogroup 1 results in around 90 percent of infections caused by members of the genus Legionella. Susceptibility to antibiotics and clinical behavior of the different species of the family Legionellaceae do not appear to be different from L. pneumophila (Roig, Carreres, & Domingo, 1993).

The natural habitat of Legionella spp. is water. Mechanisms such as favoring bacteria concentrations, make it possible for microorganisms to reach the respiratory tract and cause infection. The mode of transmission is usually by inhalation. Contaminated water is also a possible mode of transmission; some systems of aerosolization of colonized water have been shown

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(for example in transplant recipients). A more susceptible population is also found to be more prone to a protracted course and a high mortality (Roig, Carreres, & Domingo, 1993). Most studies show usual findings of fibrinopurulent, leucocytoclastic pheumonia or histiocitary pneumonia. A few reports of lung tissue examination have shown a predominant pathological pattern of plasma-cell pneumonia, organizing pneumonia, fibrosing alveolitis, and/or bronchiolitis obliterans. Unusual cases of legionnaires' disease are unresponsive to the usual most effective combination therapy (Roig, Carreres, & Domingo, 1993). Clinical Manifestations Nonspecific clinical data of legionnaires' disease is not usually distinguishable from that found in typical bacterial pneumonia that is caused by other aerobic microorganisms. Early studies stated that clinical features such as diarrhoea or central nervous system symptoms are frequent in legionellosis and can be considered suggestive of legionnaires' disease. Later studies emphasize that there is an overlap regarding clinical, radiological, and analytical signs between CAP and HAP. Acute renal failure in legionnaires' disease is rare, but when it occurs the mortality rate is high (Lin, Che

Category: Medical - L