Medicine of the Future in America

Legionella pneumophila (5)

Legionella pneumophila (5)Twenty-six patients with pneumonia due to L pneumophila were smokers (86 percent) compared with 36 (42.8 percent) patients with pneumococcal pneumonia (p<0.01). Twenty-three patients (76 percent) with Legionnaires’ disease had an underlying chronic disease: chronic obstructive bronchitis in 15, chronic heart disease in 4, immunosuppression in 3 (kidney transplantation, ulcerative colitis being treated with high doses of steroids and disseminated neoplasia) and chronic liver disease in 1 case.
The mean duration of symptoms before admission was six days for Legionnaires’ disease (range, 1 to 15 days) which was similar to that for pneumococcal pneumonia. Clinical findings of patients with Legionnaires’ disease and with pneumococcal pneumonia are given in Table 2. Fourteen patients (47 percent) had received previous antimicrobial therapy while only seven (8 percent) with pneumococcal pneumonia (p<0.05) had received antimicrobial therapy. Gastrointestinal and neurologic manifestations were more frequent in Legionnaires’ disease, whereas upper respiratory symptoms, productive cough with purulent sputum and pleuritic chest pain were more prevalent in pneumococcal pneumonia.

Table 2—CUnical Findings offtUientswith Legionnaires9 Disease and of Those with Pneumococcal Pneumonia

Clinical Findings Legionnaires*Disease

(%)

PneumococcalPneumonia

(*)

p Value
Fever 30 (100) 84 (100)
Chills 21 (70) 61 (73)
Cough 25 (83) 76 (90)
Purulent sputum 15 (50) 63 (75) <0.05
Pleuritic chest pain 9 (30) 52 (62) <0.01
Upper respiratory symptoms* 1 (3) 20 (24) <0.01
Gastrointestinalsymptomsf 9 (30) 9 (11) <0.05
Neurologicmanifestations^ 7 (23) 3 (3.5) <0.01
Previous antimicrobial therapy 14 (47) 7 (8) <0.05
This entry was posted in Pulmonary function and tagged erythromycin, etiology, legionnaires disease, Pneumonia, respiratory failure.
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