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Concept
Legionnaires' disease
Summary
Legionnaires' disease is a form of atypical pneumonia caused by any species of Legionella bacteria, quite often Legionella pneumophila. Signs and symptoms include cough, shortness of breath, high fever, muscle pains, and headaches. Nausea, vomiting, and diarrhea may also occur. This often begins 2–10 days after exposure.
A legionellosis is any disease caused by Legionella, including Legionnaires' disease (a pneumonia), Pontiac fever (a nonpneumonia illness), and Pittsburgh pneumonia, but Legionnaires' disease is the most common, so mentions of legionellosis often refer to Legionnaires' disease.
The bacterium is found naturally in fresh water. It can contaminate hot water tanks, hot tubs, and cooling towers of large air conditioners. It is usually spread by breathing in mist that contains the bacteria. It can also occur when contaminated water is aspirated. It typically does not spread directly between people, and most people who are exposed do not become infected. Risk factors for infection include older age, a history of smoking, chronic lung disease, and poor immune function. Those with severe pneumonia and those with pneumonia and a recent travel history should be tested for the disease. Diagnosis is by a urinary antigen test and sputum culture.
No vaccine is available. Prevention depends on good maintenance of water systems. Treatment of Legionnaires' disease is with antibiotics. Recommended agents include fluoroquinolones, azithromycin, or doxycycline. Hospitalization is often required. The fatality rate is around 10% for healthy persons and 25% for those with underlying conditions.
The number of cases that occur globally is not known. Legionnaires' disease is the cause of an estimated 2–9% of pneumonia cases that are acquired outside of a hospital. An estimated 8,000 to 18,000 cases a year in the United States require hospitalization. Outbreaks of disease account for a minority of cases. While it can occur any time of the year, it is more common in the summer and fall.
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Ontological neighbourhood
Related publications (22)
Related concepts (12)
Legionella
Legionella is a genus of pathogenic gram-negative bacteria that includes the species L. pneumophila, causing legionellosis (all illnesses caused by Legionella) including a pneumonia-type illness called Legionnaires' disease and a mild flu-like illness called Pontiac fever. Legionella may be visualized with a silver stain or cultured in cysteine-containing media such as buffered charcoal yeast extract agar. It is common in many environments, including soil and aquatic systems, with at least 50 species and 70 serogroups identified.
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is a strain of coronavirus that causes COVID-19, the respiratory illness responsible for the COVID-19 pandemic. The virus previously had the provisional name 2019 novel coronavirus (2019-nCoV), and has also been called human coronavirus 2019 (HCoV-19 or hCoV-19). First identified in the city of Wuhan, Hubei, China, the World Health Organization designated the outbreak a public health emergency of international concern from January 30, 2020, to May 5, 2023.
Legionella pneumophila
Legionella pneumophila is a thin, aerobic, pleomorphic, flagellated, non-spore-forming, Gram-negative bacterium of the genus Legionella. L. pneumophila is the primary human pathogenic bacterium in this group and is the causative agent of Legionnaires' disease, also known as legionellosis. In nature, L. pneumophila infects freshwater and soil amoebae of the genera Acanthamoeba and Naegleria. The mechanism of infection is similar in amoeba and human cells. L.