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Legionnaire’s Disease: Treatment, symptoms, advice and help

About Legionnaire’s Disease

Legionnaire’s disease is an infectious disease which is caused by bacteria. It mainly affects lungs causing pneumonia. It can cause respiratory distress and needs specific management.

Legionnaire’s Disease: Incidence, age and sex

Legionnaire’s disease is a common cause of pneumonia in the general population. It is especially seen in the elderly population. Both sexes are equally affected.

Signs and symptoms of Legionnaire’s Disease: Diagnosis

Legionnaire’s disease presents with fever, cough with sputum, breathlessness and chest pain. However in the elderly, these symptoms may be absent and it may present with vomiting, diarrhoea, confusion and altered mental status. There may be increased heart rate, respiratory distress and failure to maintain blood and tissue oxygenation (low oxygen saturation). There may or may not be any abnormalities on examination of the chest. X ray of the chest may reveal pneumonia involving one or more parts of the lungs. Blood tests reveal increase in white blood cell count, low sodium, impaired kidney functions, and low oxygen content in blood. Diagnosis can be established by serology or culturing bacteria from respiratory secretions.

Causes and prevention of Legionnaire’s Disease

Legionnaire’s disease is caused by a bacterium called Legionella pneumophila. The bacterium is present in respiratory secretions and is transmitted through the aerosol route (airborne) by coughing and sneezing. Transmission is also known to occur through air-conditioning ducts. Preventive measures depend on avoiding contact with the infected respiratory secretions and include wearing of mask, covering the mouth and the nose while coughing and sneezing, and frequent hand washing.

Legionnaire’s Disease: Complications

Legionnaire’s disease can cause marked respiratory distress and may lead to respiratory failure and septicaemia which may necessitate artificial ventilation and intensive care in severe cases.

Legionnaire’s Disease: Treatment

Legionnaire’s disease is a completely treatable condition with good response rates. The cornerstone of treatment is the administration of appropriate antibiotic therapy. Macrolides (Erythromycin, Clarithromycin, Azithromycin) and fluoroquinolones (Ciprofloxacin, Ofloxacin, Levofloxacin) are the commonly used agents and have good efficacy against Legionella pneumophila. In case of respiratory distress and failure to maintain oxygen saturation, intensive respiratory care may be needed.