Legionnaire's Disease

 

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Itayi Charasika from Bellarmine University's Pathophysiology of Complex Patient Problems project.

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Definition/Description

Legionnaire’s Disease is a deadly severe form of pneumonia. It is the cause of nosocomial pneumonia. This disease can be fatal. Legionnaire’s disease is a lung infection. It is a disease caused by a bacteria, known as Legionella. This disease is often screened for whenever a person is diagnosed with pneumonia because of the close resemblance Legionnaire’s has to pneumonia. Legionnaire’s disease is commonly from inhaling the bacteria.

The bacteria, Legionella, in Legionnaire’s disease can also lead to Pontiac Fever, which is like a milder version of Legionnaire’s disease. Pontiac Fever resembles the flu. If a person is diagnosed with both illnesses, then the term is Legionellosis. Unlike Legionnaire’s disease, Pontiac Fever usually clears on it own¹.

History of Disease: Legionnaire’s disease first came about in 1967 when a group of people in Philadelphia, attending an American Legion convention meeting became exposed to this disease.

Prevalence

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Characteristics/Clinical Presentation

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Associated Co-morbidities

People at risk:

•  Smokers (esp. Middle-aged/older adults who smoke cigarettes)
•  Chronic lung disease
•  Advanced age
• Alcohol abuse
• Surgery
• Recent travel with an overnight stay outside of the home
• Exposure to whirlpool spas
• Recent repairs or maintenance work on domestic plumb
•  Immune system compromised by

     - DM
     - Renal Failure
     - Cancer (esp. hematological or pulmonary malignancy)
     - AIDS

Medications

• Erythromycin (the drug of choice for prolonged period) - given early
• Rifampin is also a benefit
  

Newer Effective Therapeutic Options Include Antibiotics (Macrolides)⁴:

• Clarithromycin
• Azithromycin
•  Fluoroquinolones
  

Diagnostic Tests/Lab Tests/Lab Values

Legionnaire’s disease is diagnosed by growing bacteria on a special medium and silver staining. The bacteria is identified in the sputum and the Legionella antigen is seen in the urine⁴.

What diagnostic tests can confirm Legionnaires' disease? (http://www.cdc.gov/legionella/faq.htm⁹)

Etiology/Causes

Legionnaire’s disease is the cause of nosocomial pneumonia⁴.

 
Common places that allow Legionella transmission¹⁰:
1. Potable (drinking) water systems
2. Whirlpool spas
3. Cooling towers
Conditions for Legionella transmission¹⁰:
1. Heat
2. Stasis
3. Aerosolization

Systemic Involvement

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Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Alternative/Holistic Management (current best evidence)

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Differential Diagnosis

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Case Reports/ Case Studies

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Resources

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Recent Related Research (from Pubmed)

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References

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