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Legionella Species Community-Acquired Pneumonia : A Review of 56 Hospitalized Adult Patients FREE TO VIEW

David Lieberman; Avi Porath; Fransisc Schlaeffer; Devora Lieberman; Ida Boldur
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Affiliations: From the Division of Internal Medicine, Soroka Medical Center of Kupat Holim, and Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,  From The Microbiology Department, Assaf Harofeh Medical Center, Zerifin, Israel

Affiliations: From the Division of Internal Medicine, Soroka Medical Center of Kupat Holim, and Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,  From The Microbiology Department, Assaf Harofeh Medical Center, Zerifin, Israel


1996 BY THE AMERICAN COLLEGE OF CHEST PHYSICIANS


Chest. 1996;109(5):1243-1249. doi:10.1378/chest.109.5.1243
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Abstract

Background: In a prospective study, Legionella species (Lsp) was identified as the causative agent in 56 (16.2%) of 346 adult patients hospitalized over the course of 1 year with community-acquired pneumonia (CAP), in the Soroka Medical Center, Beer-Sheva, Israel.

Objective: To characterize patients with Lsp CAP in our study.

Methods: The diagnosis of infection with Lsp was based on serologic testing of antibodies using the indirect immunofluorescent method.

Results: In 35 (62.5%) of the patients, at least one other etiologic agent for CAP was identified in addition to Lsp. The patient population was relatively young, with relatively low rates of chronic comorbidity, and a broad spectrum of disease severity compared with previously published studies. No single epidemiologic, clinical, laboratory, or radiographic characteristic differentiated between Lsp CAP and other CAP patients in our study. Three patients (5.4%) who were not treated with erythromycin died. However, in contrast, nine patients who were treated with (β-lactam antibiotics recovered completely.

Conclusions: Lsp is a common cause of CAP in our region, usually as a coinfection with another causative agent. Lsp CAP, which cannot be characterized on the basis of clinical, routine laboratory, or radiographic data, requires specific microbiologic or serologic diagnosis. Treatment with erythromycin appears to be important to reduce mortality from this disease, but in a significant number of patients, the disease may be self-limited.


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