Antimicrobial Treatment of Legionella Pneumonia

  • Pieter L. Meenhorst
Part of the New Perspectives in Clinical Microbiology book series (NPCM, volume 4)


Legionnaires’ disease entered the medical universe when a mysterious outbreak of pneumonia affected 149 persons attending the 58th convention of the American Legion’s Pennsylvania Department in Philadelphia in July, 1976. The respiratory illness, which was soon called legionnaires’ disease by press and public alike, had a broad range of manifestations from a mild respiratory sickness to a multisystem affection involving extensive pneumonia, gastrointestinal symptoms, confusion, hepatic dysfunction, shock, and renal failure.


Sporadic Case Minimal Inhibitory Concentration Fatality Ratio Serum Glutamic Pyruvic Transaminase Minimal Bactericidal Concentration 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fraser DW, Tsai TF, Orenstein W, Parkin WE, Beecham HJ, Sharrar RG, Harris J. Millison GF, Martin SM, McDade JE, Shepard CC, Brachman PS, the field investigation team: Legionnaires’ disease: Description of an epidemic. N Eng J Med 297: 1189, 1977.CrossRefGoogle Scholar
  2. 2.
    Fraser DW, McDade JE: Legionellosis. Sc. Am. 241: 82, 1979.Google Scholar
  3. 3.
    McDade JE, Shepard CC, Fraser DW, Tsai TF, Redus MA, Dowdle WR, the laboratory investigation team: Legionnaires’ disease: Isolation of a bacterium and demonstration of its role in other respiratory disease. N Eng J Med 297: 1197, 1977.CrossRefGoogle Scholar
  4. 4.
    Brenner DJ, Steigerwalt AG, McDade JE: Classification of the Legionnaires’ disease bacterium: Legionella pneumophila, genus novum, species nova, of the family Legionellaceae, familia nova. Ann Intern Med 90: 656, 1979.PubMedGoogle Scholar
  5. 5.
    Thacker SB, Bennet JV, Tsai TF, Fraser DW, McDade JE, Shepard CC, Williams KH Jr, Stuart WH, Dull HB, Eickhoff TC: An outbreak in 1965 of severe respiratory illness caused by the Legionnaires’ disease bacterium. J Infect Dis 138: 512, 1978.PubMedCrossRefGoogle Scholar
  6. 6.
    Glick TH, Gregg MB, Berman B, Mallison G, Rhodes WW Jr, Kassanoff I: Pontiac fever. An epidemic of unknown etiology in a health department. I. Clinical and epidemiologic aspects Am J Epidemiol 107: 149, 1978.Google Scholar
  7. 7.
    Fraser DW: Legionnaires’ Disease: Four Summers’ Harvest. Am J Med 68: 1, 1980.PubMedCrossRefGoogle Scholar
  8. 8.
    Bartlett CLR: Sporadic cases of Legionnaires’ disease in Great Britain. Ann Intern Med 90: 592, 1979.PubMedGoogle Scholar
  9. 9.
    Renner ED, Helms CM, Hierholzer WJ Jr, Hall N, Wong YW, Viner JP, Johnson W, Hausler WJ Jr: Legionnaires’ disease in pneumonia patients in Iowa. A retrospective seroepidemiologic study, 1972–1977. Ann Intern Med 90: 603, 1979.PubMedGoogle Scholar
  10. 10.
    Meenhorst PL, Van der Meer JWM, Borst J: Sporadic cases of Legionnaires’ disease in the Netherlands. Ann Intern Med 90: 529, 1979.PubMedGoogle Scholar
  11. 11.
    Meyer RD, Edelstein PH, Finegold SM: Legionnaires’ disease in the immunocompromised host. Abstract International Symposium on Infections in the immunocompromised host. Veldhoven, The Netherlands, 1980.Google Scholar
  12. 12.
    O’H Tobin J, Beare J, Dunnill MS et al: Legionnaires’ disease in a transplant unit: Isolation of the causative agent from shower baths, Lancet 2: 118, 1980.CrossRefGoogle Scholar
  13. 13.
    Dondero TJ Jr, Rentdorff RC, Mallison GF et al: Outbreak of Legionnaires’ disease associated with a contaminated air-conditioning cooling tower. N Engl J Med 302: 365, 1980.PubMedCrossRefGoogle Scholar
  14. 14.
    Fliermans CB, Cherry WB, Orrison LH, Thacker L. Isolation of Legionnaires’ disease bacteria from nonepidemic aquatic habitats. Applied Environ Microbiol 37: 1239, 1979.Google Scholar
  15. 15.
    Center for Disease Control. Legionnaires’ disease-United States. Morbid Mortal Wkly Rep 27: 439, 1978.Google Scholar
  16. 16.
    Communicable Disease Report, Legionnaires’ disease 28, 1979.Google Scholar
  17. 17.
    Reid D: Benidorm episode and Legionnaires’ disease. Scott Med J 23: 118, 1978.Google Scholar
  18. 18.
    Grist NR, Reid D, Najera R: Legionnaires’ disease and the traveller. Ann Intern Med 90: 563, 1979.PubMedGoogle Scholar
  19. 19.
    Foy HM, Broome CV, Hayes PS et al: Legionnaires’ disease in a prepared medical care group in Seattle 1963–1975. Lancet 1: 767, 1979.PubMedCrossRefGoogle Scholar
  20. 20.
    Center for Disease Control-Legionellosis-Vasteräs, Sweden, Morbid Mortal Wkly Rep 29: 206, 1980.Google Scholar
  21. 21.
    Broome CV, Goings SAJ, Thacker SB, Vogt RL, Beaty HN, Fraser DW, the field investigation team. The Vermont epidemic of Legionnaires’ disease. Ann Intern Med 90: 573, 1979.PubMedGoogle Scholar
  22. 22.
    Kirby BD, Snyder KM, Meyer RD, Finegold SM: Legionnaires’disease: Report of sixty-five nosocomially axquired cases and review of the literature. Medicine 59: 188, 1980.PubMedCrossRefGoogle Scholar
  23. 23.
    Petricevic J, Presecki, Grgas J: Legionnaires’ disease in two patients following renal transplantation. Abstract International Symposium on Infections in the Immunocompromised Host. Veldhoven, the Netherlands, 1980.Google Scholar
  24. 24.
    Haley CE, Cohen ML, Halter J, Meyer RD: Nosocomial legionnaires’ disease: A continuing common-source epidemic at Wadsworth Medical Center. Ann Intern Med 90: 583, 1979.PubMedGoogle Scholar
  25. 25.
    Thomason BH, Harris PP, Hicklin MD et al: A Legionella-like bacterium related to WIGA in a fatal case of pneumonia. Ann Intern Med 91: 673, 1979.PubMedGoogle Scholar
  26. 26.
    Heber GA, Thomason BH, Harris PP et al: Pittsburgh Pneumonia Agent’: A bacterium phenotypically similar to Legionella pneumophila and identical to the TATLOCK bacterium. Ann Intern Med 92: 53, 1980.Google Scholar
  27. 27.
    Gregory DW, Schaffner W, Alford RH, Kaiser AB, McGee ZA: Sporadic cases of Legionnaires’ disease: The expanding clinical spectrum. Ann Intern Med 90: 518, 1979.PubMedGoogle Scholar
  28. 28.
    Lees AW, Tyrrell WF: Severe cerebral disturbance in Legionnaires’ disease. Lancet ii: 1336, 1978.Google Scholar
  29. 29.
    Miller AC: Early clinical differentiation between Legionnaires’ disease and other sporadic pneumonias. Ann Intern Med 90: 526, 1979.PubMedGoogle Scholar
  30. 30.
    Gasper TM, Farndon PA, Davies R: Thrombocytopenia associated with Legionnaires’ disease. Br Med J 2: 1611, 1978.PubMedCrossRefGoogle Scholar
  31. 31.
    Mould RF, Williams RJ: Hypoplastic anaemia associated with Legionnaires’ disease. Br Med J 1: 366, 1980.CrossRefGoogle Scholar
  32. 32.
    Tsai TF, Finn DR, Plikaytis BD, McCauley W, Martin SM, Fraser DW: Legionnaires’ disease: Clinical features of the epidemic in Philadelphia. Ann Intern Med 90: 509, 1979.PubMedGoogle Scholar
  33. 32.
    Kerr DN, Brewis RA, Macrae AD: Legionnaires’ disease and acute renal failure. Br Med J 2: 538, 1978.PubMedCrossRefGoogle Scholar
  34. 34.
    Case Records of the Massachusetts General Hospital: Case 17–1978. N Engl J Med 298: 1014, 1978.Google Scholar
  35. 35.
    Kirby BD, Snyder KM, Meyer RD, Finegold SM: Legionnaires’ disease: Clinical features of 24 cases. Ann Intern Med 89: 297, 1978.PubMedGoogle Scholar
  36. 36.
    Friedman HM: Legionnaires’ disease in nonlegionnaires: A report of 5 cases. Ann Intern Med 88: 294, 1978.PubMedGoogle Scholar
  37. 37.
    Dietrich PA, Johnson RD, Fairbank JT, Walke JS: The chest radiograph in Legionnaires’ disease. Radiology 127: 577, 1978.PubMedGoogle Scholar
  38. 38.
    Gump DW, Frank RO, Winn WC Jr, Foster RS Jr, Broome CV, Cherry WB: Legionnaires’ disease in patients with associated serious disease. Ann Intern Med 90:538.Google Scholar
  39. 39.
    Saravolatz LD, Burch KH, Fisher E, Madhaven T, Kiani D, Neblett T, Quinn EL: The compromised host and Legionnaires’ disease. Ann Intern Med 90: 533, 1979.PubMedGoogle Scholar
  40. 40.
    Hake KB, Van Dijke JJ, Gerberg E et al.: Legionnaires’ disease and pulmonary cavitation. Arch Intern Med 139: 485, 1979.CrossRefGoogle Scholar
  41. 41.
    Center for Disease Control. Legionnaires’ disease: Diagnosis and management. Ann Intern Med 88: 363, 1978.Google Scholar
  42. 42.
    Broome CV, Cherry WB, Winn WC, MacPherson BR Jr: Rapid diagnosis of Legionnaires’ disease by direct immunofluorescent staining. Ann Intern Med 90: 1, 1979.PubMedGoogle Scholar
  43. 43.
    Edelstein PH, Meyer RD, Finegold SH: Laboratory diagnosis of Legionnaires’ disease. Am Rev Resp Dis 121: 317, 1980.PubMedGoogle Scholar
  44. 44.
    Feeley JC, Gorman GW, Weaver RE, Mackel DC, Smith HW: Primary isolation media for the Legionnaires’ disease bacterium. J Clin Microbiol 8: 320, 1978.PubMedGoogle Scholar
  45. 45.
    Feeley JC, Gibson RJ, Gorman GW, Langford NC, Rasheed JK, Mackel DC, Baine WB: CYE agar: A primary isolation medium for the Legionnaires’ disease bacterium. J Clin Microbiol 10: 437, 1979.PubMedGoogle Scholar
  46. 46.
    Edelstein PH, Meyer RD, Finegold SH: Isolation of Legionella pneumophila from blood. Lancet 1: 750, 1979.PubMedCrossRefGoogle Scholar
  47. 47.
    Macrae AD, Greaves PW: Isolation of Legionella pneumophila from blood culture. Br Med J 2: 1189, 1979.PubMedCrossRefGoogle Scholar
  48. 48.
    Thornsberry C, Kirven LA: Beta-lactamase of the Legionnaires’ bacterium. Current Microbioloby 1: 51, 1978.CrossRefGoogle Scholar
  49. 49.
    Fraser DW, Wachsmuth I, Bopp C, Feeley JC, Tsai TF: Antibiotic treatment of guinea pigs infected with agent of Legionnaires’ disease. Lancet 1: 175, 1978.PubMedCrossRefGoogle Scholar
  50. 50.
    Lewis VJ, Thacker WL, Shepard CC, McDade JE: In vivo susceptibility of the Legionnaires’ disease bacterium to ten antimicrobial agents. Antimicrob Agents Chemother 13:-19, 1978.Google Scholar
  51. 51.
    Blackmon JA, Hicklin MD, Chandler FW, the Special Expert Pathology Panel: Legionnaires’ disease: Pathologic and historical aspects of a `new’ disease. Arch pathol Lab Med 102: 337, 1978.PubMedGoogle Scholar
  52. 52.
    Chandler FW, McDade JE, Hicklin MD, Blackmon JA, Thomason BM, Ewing EP Jr: Pathologic findings in guinea pigs inoculated intraperitoneally with the Legionnaires’ disease bacterium. Ann Intern Med 90: 671, 1979.PubMedGoogle Scholar
  53. 53.
    Horwitz MA, Silverstein SC: The Legionnaires’ disease bacterium grows intracellularly in human monocytes. Abstract presented for the American Society for Clinical Investigation. Clin Res 28: 512A, 1980.Google Scholar
  54. 54.
    McDade JE, Shepard CC: Virulent to avirulent conversion in the Legionnaires’ disease bacterium and its effect on isolation techniques. J Infect Dis 139: 707, 1979.PubMedCrossRefGoogle Scholar
  55. 55.
    Beaty HN, Miller AA, Broome CV et Al: Legionnaires’ disease in Vermont, May to October 1977. JAMA 240: 127, 1978.PubMedCrossRefGoogle Scholar
  56. 56.
    Garrod LP, Waterworth PH: Methods of testing combined antibiotic bactericidal action and the significance of the results. J Clin Path 15: 328, 1962.PubMedCrossRefGoogle Scholar
  57. 57.
    Keys TF: A sporadic case of pneumonia due to Legionnaires’ disease. Mayo Clin Proc 52: 657, 1977.PubMedGoogle Scholar
  58. 58.
    Krech U, Kohli P, Pagon S: Legionnaires’ disease in Switzerland. Schweiz Med Wochenschr 108: 1653, 1978.PubMedGoogle Scholar
  59. 59.
    Acocella G, Hamilton-Miller JMT, Brumfitt W: Can rifampicin use be safely extended? Evidence for non-emergence of resistant strains of mycobacterium tuberculosis. Lancet 1: 740, 1977.PubMedCrossRefGoogle Scholar
  60. 60.
    Meenhorst PL, Van der Meer JWM, Van Brummelen P: Een patiënt met Legionairsziekte in Nederland, Ned T Geneesk 122: 507, 1978.PubMedGoogle Scholar

Copyright information

© Martinus Nijhoff Publishers, The Hague 1981

Authors and Affiliations

  • Pieter L. Meenhorst

There are no affiliations available

Personalised recommendations