Legionella: Difference between revisions
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==Background== | ==Background== | ||
*Gram negative aerobe | |||
* ''L. pneumophila:'' associated with pneumonia and Pontiac Fever | |||
*Increased incidence with hot, humid, weather and thundershowers; outbreaks have been associated with cooling towers.<ref name="Fisman Lim Wellenius Johnson 2005 pp. 2066–2073">{{cite journal | last=Fisman | first=David~N. | last2=Lim | first2=Suet | last3=Wellenius | first3=Gregory~A. | last4=Johnson | first4=Caroline | last5=Britz | first5=Phyllis | last6=Gaskins | first6=Meredith | last7=Maher | first7=John | last8=Mittleman | first8=Murray~A. | last9=Victor~Spain | first9=C. | last10=Haas | first10=Charles~N. | last11=Newbern | first11=Claire | title=It's Not the Heat, It's the Humidity: Wet Weather Increases Legionellosis Risk in the Greater Philadelphia Metropolitan Area | journal=The Journal of Infectious Diseases | publisher=Oxford University Press (OUP) | volume=192 | issue=12 | year=2005 | pages=2066–2073 | url=https://doi.org/10.1086%2F498248 | doi=10.1086/498248 | accessdate=2017-03-15}}</ref> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 22:34, 15 March 2017
Background
- Gram negative aerobe
- L. pneumophila: associated with pneumonia and Pontiac Fever
- Increased incidence with hot, humid, weather and thundershowers; outbreaks have been associated with cooling towers.[1]
Differential Diagnosis
Causes of Pneumonia
Bacteria
Viral
- Common
- Influenza
- Respiratory syncytial virus
- Parainfluenza
- Rarer
- Adenovirus
- Metapneumovirus
- Severe acute respiratory syndrome (SARS)
- Middle east respiratory syndrome coronavirus (MERS)
- 2019-nCoV (COVID-19)
- Cause other diseases, but sometimes cause pneumonia
Fungal
- Histoplasmosis
- Coccidioidomycosis
- Blastomycosis
- Pneumocystis jirovecii pneumonia (PCP)
- Sporotrichosis
- Cryptococcosis
- Aspergillosis
- Candidiasis
Parasitic
Management
- First line
- Alternatives:
- Doxycycline
- Tigecycline
- Respiratory fluoroquinolone for severe disease[2]
Antibiotic Sensitivities[3]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
Table Overview
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See Also
References
- ↑ Template:Cite journal
- ↑ Burke et Al. Legionnaires Disease Treatment & Management. Aug 18, 2014. http://emedicine.medscape.com/article/220163-treatment#d11
- ↑ Sanford Guide to Antimicrobial Therapy 2014