| [ Summary ] |
Legionella pneumonia is one form of community acquired, nosocomial pneumonia caused by the legionella species. Water is the major natural reservoir for legionella. The pathogen is found in many natural and artificial aquatic environments such as cooling towers or water systems in buildings, including hospitals. Legionella pneumophila is a fatal pathogen for immunocompromised patients. Patients with diabetes, chronic kidney disease and immunosuppression have been consistently implicated as being at risk. Elderly dialysis patients have increased risk for the infection. Diagnosis of Legionella pneumonia remains a clinical challenge. Legionella pneumonia is not always strongly suspected because of its non-specific indications and symptoms, and indefinite urinary antigen tests. These tests indicate only the dominant species and the serogroup ; e.g. Legionella pneumophila serogroup 1. These tests, while routinely available do not provide the desired sensitivity. Fluoroquinolones have demonstrated improved clinical outcomes and decreased complications. The fatality rate for these patients is 10-20 %. Early recognition and treatment of complication will likely result in reduced mortality and morbidity. Legionella pneumonia should be recognized as a potentially mortal form of pneumonia for elderly dialysis patients. |