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Introduction and historical perspective Introduction and historical perspective
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Aetiology and pathology Aetiology and pathology
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The organism The organism
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Pathology Pathology
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Epidemiology Epidemiology
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Prevention Prevention
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Clinical features Clinical features
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Legionella pneumonia Legionella pneumonia
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Clinical features Clinical features
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Differential diagnosis Differential diagnosis
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Clinical investigation Clinical investigation
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Radiographic features Radiographic features
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Prognosis and complications Prognosis and complications
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Pontiac fever Pontiac fever
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Laboratory diagnosis Laboratory diagnosis
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Treatment Treatment
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Prognosis Prognosis
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Areas of uncertainty Areas of uncertainty
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Likely future developments Likely future developments
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Further reading Further reading
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7.6.38 Legionellosis and legionnaires’ disease
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Published:May 2010
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This version:May 2012
Updated in this version:
Update:
Minor amendments to aetiology, epidemiology, and diagnosis sections.
Cite
Extract
Essentials
Introduction and historical perspective
In 1976, an outbreak of pneumonia affected 221 and killed 34 members of the American Legion who had attended a convention in a Philadelphia hotel. A newly identified organism, Legionella pneumophila, was discovered and named after the outbreak. Since then many different species of the family Legionellaceae have been discovered. Clinical illness is referred to as legionellosis, and there are two principal syndromes: legionnaires’ disease (pneumonia) and Pontiac fever (a self-limiting influenza-like illness).
Aetiology and pathology
The organism
The Legionellaceae are aerobic nonsporing Gram-negative bacilli whose cell walls contain distinctive branched-chain fatty acids and lipo-oligosaccharide (LOS). They do not grow on routine media; specialized media such as buffered charcoal yeast extract (BCYE) are required for growth.
Of the 50 formally recognized legionella species, L. pneumophila is the principal cause of human infections. Of the 70 or more serogroups (SG) of L. pneumophila, serogroups 1, 4, and 6 are the ones most frequently isolated in human infection. There are 17 species other than L. pneumophila that have been implicated in human infections; these include L. micdadei, L. bozemanii, L. dumoffi, and L. longbeachae.
Update:
Minor amendments to aetiology, epidemiology, and diagnosis sections.
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