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Legionellosis, (Legionnaire Disease) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

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This book describes Legionellosis, Diagnosis and Treatment and Related Diseases
I always thought that Legionnaire’s Disease is a French disease because of the word Legionnaire but it is not related to France but the Legionella bacteria that like to grow in wet places.
The bacterium causing the illness among people attending a convention of the American Legion was named Legionella pneumophila and the name of the illness was changed to Legionellosis.

Legionellosis (Legionnaire's Disease) is an infection of the lungs and airways produced by Legionella bacteria
Legionellosis (Legionnaire's Disease) can produce a type of atypical pneumonia.
Signs and symptoms are cough, shortness of breath, high fever, muscle pains, and headaches.
This often begins two to ten days after exposure.
The bacterium is found naturally in fresh water.
It can pollute hot water tanks, hot tubs, and cooling towers of large air conditioners.
It is normally spread by breathing in mist that contains the bacteria.
It normally does not spread directly between people and most people who are exposed do not become infected.
The patient gets the infection by breathing in droplets of water which contain legionella germs (bacteria) from contaminated water systems
Pontiac fever is a mild infection also caused by legionella normally without pneumonia formation
Legionnaires' disease is normally spread by the breathing in of aerosolized water and soil contaminated with the Legionella bacteria
The bacteria grow best at warm temperatures between 25 and 45 C (77 and 113 F), with an optimum temperature of 35 C (95 F).
Temperatures above 60 C (140 F) kill it.
Sources where temperatures allow the bacteria to thrive are hot water tanks, cooling towers, and evaporative condensers of large air conditioning systems, such as those often found in hotels and large office buildings

Symptoms tend to get worse during the first 4 - 6 days.

They most often improve in another 4 - 5 days.

Symptoms start off with:
1.Sudden onset of malaise
2.High fever 39-40 C
3.Chills, rigors
5.Dry coughs
Diagnosis is by a blood and urinary antigen test and sputum culture.
Chest x-ray shows patchy consolidation and evidence of pneumonia
Indirect legionna bacterial antibody is higher than 1.256
Treatment is started with antibiotics as soon as possible.
Normally they are given intravenously (IV) which means into a vein
IV fluids are often given to keep the patient well hydrated
Delay in giving the proper antibiotic leads to higher mortality.
Recommended antibiotics are fluoroquinolones, azithromycin, or doxycycline.
Isolation in hospital is not necessary.
Pulmonary care -nebulizer, oxygen, deep breathing exercises, steam inhalation, cough mixture
The most successful antibiotics are most macrolides, tetracyclines, ketolides, and quinolones
Macrolides (azithromycin) are given in all age groups, while tetracyclines (doxycycline) are given for children above the age of 12 and quinolones (levofloxacin) above the age of 18
Rifampicin can be used in combination with a quinolone or macrolide
Patients with moderate or mild pneumonia in whom Legionnaires’ disease is suspected on strong grounds or in whom a rapid positive diagnosis has been achieved using urinary legionella antigen assays may be switched to better agents if they are failing to improve on initial therapy.
Patients on older macrolides and β-lactams may be switched to azithromycin or quinolones.
Initial, empirical therapy increasingly is azithromyin or quinolones for hospitalized patients with suspected legionellosis.
Intensive care with supportive treatments such as assisted ventilation may be needed if the pneumonia is severe.

Chapter 1 Legionellosis
Chapter 2 Causes

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