Serological evidence ofLegionellaspecies infection in acute exacerbation of COPD

To the Editor: We are concerned about the alleged aetiological role of Legionella spp. in acute exacerbations of chronic obstructive pulmonary disease (AECOPD), as has been recently suggested by both Lieberman et al. 1 in their study published in the European Respiratory Journal , and Ewig 2 in an editorial in the same issue 2. To the best of our knowledge, the distinctive results of the study by Lieberman et al. 1 have not been reported in any other aetiological survey of AECOPD. A recent, in-depth review of bacterial infection in chronic obstructive pulmonary disease, by a worldwide expert on this subject, does not even mention any role for Legionella spp. in AECOPD 3. Although attachment to bronchial cells is the first step of Legionella spp. infection, it is well known that the primary pathogenic process takes place at the macrophage cell level. There are no consistent data that might favour a theoretical isolated infectious bronchitis without any pneumonic involvement 4. In …