Legionellosis (Legionella pneumophilia (90%), Legionary Disease, ICD-10: A48.1
Contents
Definition
Bacterial infection that causes Legionellosis / Legionnaires' disease or Pontiac fever.
- Initially, the infection can be reminiscent of systemic rheumatic diseases with lethargy, headaches, muscle pain and impaired lung and kidney function.
- In case of a weakened immune system such as during immunosuppressive, anti-rheumatic treatment, after organ transplantation or by the wood HIV infection, legionellosis can be especially severe
Incubation
It lasts 10-20 days between infection and outbreaks of symptoms
Symptoms
- Fever
- Frost attacks (fever chilliness)
- Muscle pain, headaches, exhaustion
- Headache
- Cough (dry cough or with a little expectorate)
- Pain in the lung areas (thoracic)
- Legionnaires' disease
- Dry cough and pneumonia
- Abdominal pain and diarrhea
- Renal inflammation (glomerulonephritis)
- Renal impairment
- Ataxia (uncoordinated movements)
- Serious disease course
- Pontiac fever
- Influenza-like
- Muscle pain
- Duration 2-XNUM days
Complications
- Legionellosis
- DIC (bleeding)
- Rhabdomyolysis (Muscle)
- Mental confusion / neuropathy
Diagnosis
- Lung CT
- Infiltrates at the bottom of both lungs (Bilateral basal infiltrates)
- Pleural fluid
- Urine antigen test is easy to perform, but only detects serotype-1. which accounts for 70% of cases
- Legionella detection (PCR investigations and cultivation) in urine and saliva (BAL fluid)
- PCR after BAL, or from urine / serum also possible. Cultivation from airways nevertheless important
- Antibodies in serum should be checked with 3-6 weekly intervals
- Leukocytosis, Hyponatremia (less than 130), thrombocytopenia, hepatic enzyme proliferation
Wrong diagnosis (Differential diagnoses)
- Antisynthetase syndrome
- Meningitis (Meningitis)
- Flu
- pneumonia of other reasons
- Opportunistic infections, others
- Pleurisy
- Systemic lupus erythematosus (SLE)
Treatment
- Quinolones (ciprofloxacin, levofloxacin and more)
- Macrolides (azithromycin, clarithromycin)
Literature
Opportunistic infections, BINDEVEVSSYKDOMMER.no
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