Disease/Syndrome |
Legionellosis |
Category |
Infection, Occupational |
Acute/Chronic |
Acute-Severe |
Synonyms |
Legionnaires' disease; Legionella pneumophilia infection |
Biomedical References |
Search PubMed |
Comments |
FINDINGS: More than 50% of patients present with fever >103 degrees F. The cough usually becomes productive within a few days. About 50% of patients have chest pain and dyspnea, and about 15% to 50% develop respiratory failure. Leukocytosis, diarrhea, and abdominal pain are common. Recent case series show that Legionella infections are indistinguishable from other bacterial pneumonias by routine clinical or laboratory findings. Hyponatremia does appear to be more common in Legionella pneumonia. Almost all patients have evidence of pneumonia on chest x-ray by day 3, and about 1/3 of patients have pleural effusions. Extrapulmonary infections are not common. [CCDM, p. 292-5] Relative bradycardia is a common finding. Some patients present with severe pneumonia and shock. [Lexi-ID, p. 193] In about 50% of patients, the cough produces phlegm. Occasional findings are hemoptysis, confusion, seizures, and myoglobinuria. Extrapulmonary dissemination may occur in immunocompromised patients. [PPID, p. 2716-17] EPIDEMIOLOGY: People become infected by inhaling mists from contaminated water, e.g., cooling towers, humidifiers, whirlpool spas, decorative fountains, and respiratory therapy devices. [CCDM] Pontiac fever is another disease caused by exposure to mists contaminated with Legionella pneumophilia. See "Pontiac fever." |
Latency/Incubation |
2-10 days, usually 5-6 days |
Diagnostic |
Urine antigen testing is easy to perform and highly specific. Sensitivity is in the range of 70-80%. Cultures, immunofluorescent microscopy, and detection of antibodies are specific tests, but lack sensitivity. [PPID, p. 2717-8] |
ICD-9 Code |
482.8 |
Effective Antimicrobics |
Yes |
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Reference Link |
OSHA: Legionnaires' Disease |
Related Information in Haz-Map |
Symptoms/Findings |
Symptoms/Findings associated with this disease:
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Job Tasks |
High risk job tasks associated with this disease:
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