Via practica 4/2010

Legionelloses – clinical picture, epidemiology, diagnostics, therapy

Legionellosis is an infectious disease caused by gramnegative bacteria, legionellae. The disease could manifest as life threatening atypical pneumonia, Legionnaires´ disease or as flu-like nonpneumonic form, Pontiac fever, sometimes is the infection asymptomatic. It is caused by inhalation of water aerosol contaminated by legionellae. In Europe about 5 000 – 6 000 legionella cases are notified per year (incidence rate of 10 – 11 per million population), in Slovakia this infection is rare, 0 – 9 cases were notified per year (incidence rate of 0,2 – 1,7 per million population). The methods available to diagnose legionellosis are mainly culture of samples from lower respiratory system on BCYEα selective media, urinary antigen detection and detection of specific antibodies by serological tests. In therapy of Legionnaires´ disease newer macrolides (macroazalides) and fluoroquinolones (levofloxacin) are currently used. Dosage, duration of therapy, combinations should be recommended according to severity of disease and risk factors (immunosupression) of patients.

Keywords: Legionnaires´disease, Pontiac fever, legionellae, diagnostics, therapy