A Simple guide to Legionnaire's Disease

A Simple guide to Legionnaire's Disease
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What is Legionnaire's Disease?
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Legionnaire's Disease is an acute, infectious disease of the respiratory tract caused by the bacillus Legionella pneumophilia, a Gram negative, non-sporulating aerobic micro-organism..
The bacteria is found mostly in soil and water.

How is Legionnaire's Disease transmitted?
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Legionnaire's Disease is transmitted through the air or in dust associated with movement of soil or contaminated air from air conditioner units.
It is highly infectious.
Incubation period is 10-20 days.
The organism enters the blood and then enter the cells of the lower respiratory tract

The infections occur in persons of all ages but peak incidence is 50-60 years. Males are affected twice as often as females.
Predisposing factors are:
pre-existing lung disease
heavy smoking
low immune patients such as cancer
What are the Signs and Symptoms of Legionnaire's Disease?
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Symptoms start off with:
1. sudden onset of malaise
2. high fever 39-40 degrees centigrade
3. chills and rigors
4. headache
5. dry cough
6. diarrhea
7. upper and lower gastrointestinal bleeding
8. difficult breathing
9. slow heart rate
10. confusion and dilirium

How to diagnose Legionnaire's Disease?
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1.Symptoms of
a.prodromal viral like disease (myalgia, malaise, headache)
b.dry cough, confusion, diarrhea
c.lymphopenia without neutropenia
d.hyponatremia

2.ESR raised very high somtimes > 80
3.moderate leucocytosis with lymphopenia
4.low blood sodium
5.low blood calcium
6.abnormal liver function tests with albumin and raised SGOT
7.Urine shows protein and blood
8.Chest x-ray show patchy consolidation usually confined to one lobe
9.Indirect legionna bacterial antibody higher than 1.256
10.symptoms of renal failure

What are the complications of Legionnaire's Disease?
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The complications are:
1.pneumonia
2.liver dysfunction
3.renal failure

What is the Treatment of Legionnaire's Disease?
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Isolation in hospital is unnecessary.
1.Antibiotics (erythromycin or rifampicin) are used in the treatment of Legionnaire's Disease.
2.Tetracycline can be given
3.pulmonary care -nebulizer, oxygen, deep breathing exercises may be necessary if there is breathing difficulty

Besides antibiotics, the following will help:
Steam inhalation
cough mixtures
avoid smokes, dust, dry air,sudden temperature change

What is the Prevention for Legionnaire's Disease?
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Avoiding dust
Proper cleaning of air conditioners and ventilation system

Prognosis of Legionnaire's Disease
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Early therapy with antibiotics produce good results
low mortality rates as early cases are detected
Rarely pulmonary fibrosis develops as remnant from disease.