Legionnaire's Disease: A Clinical Diagnostic Approach

Infect Dis Clin North Am. 2017 Mar;31(1):81-93. doi: 10.1016/j.idc.2016.10.007.

Abstract

Legionnaire's disease is a nonzoonotic atypical pneumonia caused by Legionella sp that occurs sporadically or in outbreaks. Legionnaire's disease pneumonia is accompanied by several extrapulmonary clinical and laboratory findings. Rather than testing all pneumonias for Legionnaire's disease, the clinical challenge is to recognize the diagnostic significance of Legionnaire's disease's. The pretest probability of Legionnaire's disease is increased if several characteristic extrapulmonary findings are present. Similarly, if certain key findings are absent, Legionnaire's disease may be eliminated from further diagnostic consideration. If characteristic clinical findings are present, then specific tests should be ordered to confirm or rule out Legionnaire's disease.

Keywords: C-reactive protein; Erythrocyte sedimentation rate; Ferritin; Hypophosphatemia; Microscopic hematuria; Relative bradycardia.

Publication types

  • Review

MeSH terms

  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Disease Outbreaks
  • Ferritins / blood
  • Humans
  • Hyponatremia
  • Hypophosphatemia
  • Legionnaires' Disease* / diagnosis
  • Legionnaires' Disease* / physiopathology
  • Pneumonia, Bacterial

Substances

  • C-Reactive Protein
  • Ferritins