Advertisement

Approach to Severe Legionellosis

  • Jorge Roig
  • Christian Domingo
Chapter
  • 67 Downloads
Part of the Perspectives on Critical Care Infectious Diseases book series (CCID, volume 3)

Abstract

Since its first isolation more than twenty years agoLegionella pneumophilahas become a well-established etiologic agent of both community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) (1). The reported incidence of legionellosis in those cases of CAP in which a microbiologic diagnosis may be made ranges from 2 to 27%, depending on the geographical area under consideration and the inclusion criteria of the study (2). The percentage tends to be greater in series of CAP that require hospitalization than in those that can be treated on an outpatient basis. The highest percentages have been reported in series characterized by the severity of the illness.

Keywords

Respir Crit Acute Disseminate Encephalomyelitis Nonspecific Interstitial Pneumonia Severe Community Pontiac Fever 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Stout JE., Yu VL. Legionellosis. N Eng J Med 1997;337:7–682.CrossRefGoogle Scholar
  2. 2.
    Roig J., Domingo C, Morera J. Legionnaires’ disease. Chest 1994;105:25–1817.CrossRefGoogle Scholar
  3. 3.
    Sanchez-Nieto JM, Torres A, Garcia-Cordoba F, El-Ebiary M, Carrillo A, Ruiz J, Nunez ML, Niederman M. Impact of invasive and noninvasive quantitative culture sampling on outcome of ventilator-associated pneumonia: a pilot study. Am J Respir Crit Care Med 1998;157:6–371.Google Scholar
  4. 4.
    Leeper KV Jr, Torres A. Community-acquired pneumonia in the intensive care unit. Clin Chest Med 1995;16:71–155.Google Scholar
  5. 5.
    Lieberman D, Porath A, Schlaeffer F, Lieberman D., Boldur I.Legionellaspecies community-acquired pneumonia. A review of 56 hospitalized adult patients. Chest 1996;109:9–1243.CrossRefGoogle Scholar
  6. 6.
    Lo Presti F, Riffard S, Vandenesch F, Reyrolle M, Ronco E, Ichai P, Etienne J. The first clinical isolate ofLegionella parisiensisfrom a liver transplant patient with pneumonia. J Clin Microbiol 1997;35:9–1706.Google Scholar
  7. 7.
    O’Connell WA, Dhand L, Cianciotto NP. Infection of macrophage-like cells byLegionellaspecies that have not been associated with disease. Infect Immun 1996; 64:4–4381.Google Scholar
  8. 8.
    Vogel JP, Andrews HL, Wong SK, Isberg RR. Conjugative transfer by the virulence system ofLegionella pneumophila.Science 1998;279:6–873.Google Scholar
  9. 9.
    Miyamoto H, Maruta K, Ogawa M, Beckers MC, Gros P. Yoshida S. Spectrum ofLegionellaspecies whose intracellular multiplication in murine macrophages is genetically controlled by Lgnl. Infect Immun 1996;64:5–1842.Google Scholar
  10. 10.
    Andrews HL, Vogel JP, Isberg RR. Identification of linkedLegionella pneumophilagenes essential for intracellular growth and evasion of the endocytic pathway. Infect Immun 1998;66:8–950.Google Scholar
  11. 11.
    Spieker S, Petersen D, Rolfs A, Fehrenbach F, Kuntz R. Seuffer RH, Fetter M, Dighans J. Acute disseminated encephalomyelitis following Pontiac fever. Eur Neurol 1998;40:72–169.CrossRefGoogle Scholar
  12. 12.
    Pedro-Botet ML, Sabria-Leal M, Haro M, Rubio C, Gimenez G, Sopena N, Tor J. Nosocomial and community-acquiredLegionellapneumonia: clinical comparative analysis. Eur Respir J 1995;8:33–1929.CrossRefGoogle Scholar
  13. 13.
    Sopena N, Sabria-Leal M. Pedro-Botet ML, Padilla E, Dominguez J, Morera J, Tudela P. Comparative study of the clinical presentation ofLegionellapneumonia and other community-acquired pneumonias. Chest 1998;113:200–1195.CrossRefGoogle Scholar
  14. 14.
    Rello J. Prescription of macrolides in community-acquired pneumonia. Science or art?. Chest 1998;113:8–1155.CrossRefGoogle Scholar
  15. 15.
    Klinger JR, Sanchez MP, Curtin LA, Durkin M, Matyas B. Multiple cases of life-threatening adenovirus pneumonia in a mental health care center. Am J Respir Crit Care Med 1998:157:9–645.Google Scholar
  16. 16.
    Byrd RP Jr, Roy TM. Rhabdomyolysis and bacterial pneumonia. Respir Med 1998;92:62–359.CrossRefGoogle Scholar
  17. 17.
    Roig J. Martinez-Benazet J. Salvador J. Radiologie features of legionellosis. Curr Top Radiol 1998;1:6–101.Google Scholar
  18. 18.
    EI-Ebiary M, Sarmiento X, Torres A, Nogue S, Mesalles E, Bodi M, Almirall J. Prognostic factors of severeLegionellapneumonia requiring admission to ICU. Am J Respir Crit Care Med 1997;156:72–1467.Google Scholar
  19. 19.
    Ewig S, Ruiz M, Mensa J., Marcos MA., Martinez JA., Arancibia F., Niederman MS, Torres A. Severe community-acquired pneumonia. Assessment of severity criteria. Am J Respir Crit Care Med 1998;158:8–1102.Google Scholar
  20. 20.
    La Scola B, Michel G, Raoult D. Isolation ofLegionella pneumophilaby centrifugation of shell vial cell cultures from multiple liver and lung abscesses. J Clin Microbiol 1999;37:7–785.Google Scholar
  21. 21.
    Koch CA, Robyn JA, Coccia MR. Systemic lupus erythematosus: a risk factor for pneumonia caused byL. micdadei ?Arch Intern Med 1997;157:1–2670.Google Scholar
  22. 22.
    Maruta K, Miyamoto H, Hamada T, Ogawa M, Taniguchi H, Yoshida S. Entry and intracellular growth ofLegionella dumoffiiin alveolar epithelial cells. Am J Respir Crit Care Med 1998;157:74–1967.Google Scholar
  23. 23.
    Dominguez JA, Gali N. Pedroso P, Fargas A. Padilla E, Manterola JM, Matas L. Comparison of the BinaxLegionellaurinary antigen enzyme immunoassay (EIA) with the BiotestLegionellaurin antigen EIA for detection ofLegionellaantigen in both concentrated and nonconcentrated urine samples. J Clin Microbiol 1998;36:22–2718.Google Scholar
  24. 24.
    Murdoch DR, Walford EJ, Jennings LC, Light GJ, Schousboe Ml. Chereshsky AY, Chambers ST, Town GI. Use of the polymerase chain reaction to detectLegionellaDNA in urine and serum samples from patients with pneumonia. Clin Infect Dis 1996;23:80–475.CrossRefGoogle Scholar
  25. 25.
    Musso D, Raoult D. Serological cross-reactions betweenCoxiella burnetiiandLegionella micdadei.Clin Diagn Lab Immunol 1997;4:12–208.Google Scholar
  26. 26.
    Tkatch LS. Kusne S, Irish WD, Krystofiak S, Wing E. Epidemiology ofLegionellapneumonia and factors associated withLegionella-relatedmortality at a tertiary care center. Clin Infect Dis 1998:27:86–1479.CrossRefGoogle Scholar
  27. 27.
    Roig J, Carreres A, Domingo C. Treatment of Legionnares’ disease. Drugs 1993;46:63–79.PubMedCrossRefGoogle Scholar
  28. 28.
    Klein NC, Cunha BA. Treatment of Legionnaires’ disease. Semin Respir Infect 1998;13:6–140.Google Scholar
  29. 29.
    Edelstein PH. Antimicrobial chemotherapy for Legionnaires disease: time for a change. Ann Intern Med 1998:129:30–328.Google Scholar
  30. 30.
    Ramirez JA, Srinath L, Ahkee S, Huang SA, Raff MJ. Early switch from intravenous to oral cephalosporins in the treatment of hospitalized patients with community-acquired pneumonia. Arch Intern Med 1995:155:6–1273.Google Scholar
  31. 31.
    Stout JE, Arnold B, Yu VL. Activity of azithromycin, clarithromycin, roxithromycin, dirithromycin, quinupristin/dalfopristin and erythromycin againstLegionellaspecies by intracellular susceptibility testing in HL-60 cells. J Antimicrob Chemother 1998;41:91–289.Google Scholar
  32. 32.
    Martin SJ, Pendland SL, Chen C. Schreckenberg P, Danzinger LH. In vitro sinergy testing of macrolide-quinolone combination against 41 clinical isolates ofLegionella.Antimicrob Agents Chemother 1996;40: 21–1419.Google Scholar
  33. 33.
    Morley JN, Smith LC, Baltch AL, Smith RP. Recurrent infection due toLegionella pneumophilain a patient with AIDS. Clin Infect Dis 1994;19:12–130.CrossRefGoogle Scholar
  34. 34.
    Gattinoni L, Pelosi P, Suter PM, Pedoto A, Vercesi P, Lissoni A. Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease. Different syndromes?. Am J Respir Crit Care Med 1998:158:3–11.PubMedGoogle Scholar
  35. 35.
    Cottin V, Donsbeck AV, Revel D. Loire R. Cordier JF. Nonspecific interstitial pneumonia. Individualization of a clinicopathological entity in a series of 12 patients. Am J Respir Crit Care Med 1998;158:93–1286.Google Scholar
  36. 36.
    Matsubara S, Akashi S, Naitoh K. Nakahara Y, Hayashi S. SevereLegionella micdadeipneumonia effectively treated with hemofiltration therapy. Nihon Kokyuki Gakkai Zasshi 1998;36:90–886.Google Scholar
  37. 37.
    Skerret S.l, Martin TR. Intratracheal interferon-gamma augments pulmonary defenses in experimental legionellosis. Am J Respir Crit Care Med 1994;149:8–50.Google Scholar
  38. 38.
    Katz SL. Future vaccines and a global perspective. Lancet 1997;350:70–1767.Google Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Jorge Roig
    • 1
  • Christian Domingo
    • 2
  1. 1.Hospital Nostra Senyora de MeritxellEscaldesAndorra
  2. 2.Corporació Sanitària Parc TaulíSabadellSpain

Personalised recommendations