Legionella pneumophila: Diagnosis and Management for the Critically Ill and Septic Patient: A Review of the Literature

This is the authors' abstract. We don't add key points for this paper.

Legionnaires disease (LD) is caused by a gram-negative aerobic bacterium, Legionella pneumophila, which is an important cause of both community-acquired and nosocomial pneumonia. Although an uncommon pathogen, L. pneumophila is associated with significant morbidity and mortality if left untreated. The clinical manifestations surrounding LD are often unreliable for diagnosis, underlining the importance of the urinary antigen test and cultures of the lower respiratory tract. As a primarily intracellular atypical organism, treatment modalities aimed at penetrating the bacterial cell wall are preferred and include the use of fluoroquinolones and macrolides. Several studies have attempted to determine the treatment of choice for L. pneumophila; however, no current algorithm exists. Prevention of LD is aimed at proper maintenance of building cooling towers, plumbing design, and construction, in addition to chemoprophylaxis in a subgroup of immunocompromised patients. In this review we outline the clinical manifestations with subsequent diagnosis, summarize the available diagnostic tools for LD, and evaluate the current literature regarding treatment and management.