In the last 30 years, there has been an increase in the incidence of infectious lesions of the bronchi and lungs with atypical pathogens. Symptoms change, difficulties arise with the diagnosis, the pathology is severe. These diseases include Legionella pneumonia. Every tenth patient with pneumonia has symptoms of this type of pathology.

Features of symptoms

Pneumonia of this form proceeds with such features, which can be difficult to distinguish even for specialists. Clinical manifestations unusual for pneumonia complicate diagnosis and postpone the start of treatment.

There are 3 forms of legionella pneumonia:

Name	Description
Legionnaires’ disease	Pneumonia develops in 5% of patients and is difficult
Acute respiratory pathology	Occurs in 95% of cases, characterized by the fact that the disease does not affect the lungs
Acute fever with skin eruptions	It is observed in 5% of sick people

The classification shows that legionellosis rarely affects the lungs. Usually this type of pneumonia begins acutely. After the incubation period (from 6 hours to 10 days), severe fatigue, decreased appetite and body weight, migraine, dry cough appear.

Additional symptoms:

Severe migraine

• increased migraine;
• temperature rise up to 41 ° С;
• chills;
• joint and muscle pain.

Also, with pneumonia, hemoptysis may occur. It is accompanied by intense soreness. Pleurisy is more likely to occur. Every third patient with this type of pneumonia has respiratory failure (cyanosis of the skin, shortness of breath, increased heart rate).

General intoxication of the body leads to disturbances in the work of other internal organs. Most often this is a problem with the digestive system. Vomiting, abdominal pain begins, food is poorly digested, resulting in diarrhea.

Kidney failure

From the side of the central nervous system, loss of orientation in space, depression, fainting can be expected. The serious condition of the patient can provoke toxic shock, kidney failure.

With proper treatment, legionella pneumonia can be defeated in 3 weeks. With an incorrect diagnosis, without timely assistance due to respiratory failure, the patient may die.

Causes of the disease

The causative agent of this type of pneumonia is the legionella bacteria. The pathology was recorded in 1976. In Philadelphia, at the convention of legionnaires, almost all the participants who lived in the same hotel became infected. Colonies of the pathogen were found in the ventilation of the hotel, and the bacteria were named after the legionnaires. Susceptibility to it is very high, everyone can easily become infected, the elderly and young children are especially susceptible to infection.

A pathogenic microorganism enters the human respiratory system with food, but more often by airborne droplets. It can penetrate through air conditioners, central ventilation system. Bacteria multiply in swimming pools, artificial reservoirs, summer cottages, massage baths.

Not all people infected with Legionella get sick instantly. Strong immunity is able to withstand an atypical pathogen. There are factors that trigger the onset of legionella pneumonia:

Immunodeficiency

• immunodeficiency (congenital and acquired);
• some chronic diseases (vascular and heart damage, lungs, diabetes mellitus);
• elderly age;
• alcohol abuse, prolonged smoking;
• long-term use of certain medications (antibiotics, cytostatics).

A person is not a source of infection, even with close contact with a patient, re-infection does not occur. Animals and birds also cannot tolerate Legionella pneumonia.

Diagnostics

Blood and urine tests

To clarify the disease, during the diagnosis, many factors of the patient’s life are taken into account – rest in hotels, work related to sewerage, industrial wastewater, air conditioning, water environment, central ventilation.

The presence of inflammation is determined by standard blood and urine tests. It is necessary to take a biochemical blood test to monitor the condition of the organs. Also carried out a microbiological study of flushing from the bronchi and sputum, serological examination (RIF, ELISA). In the acute period of pneumonia, the pathogen can be identified using PCR (polymerase chain reaction).

Of the instrumental diagnostic methods, x-rays are used. It allows you to detect foci of pneumonia in the lung tissue, to timely identify the development of pleurisy. Bronchoscopy is also prescribed. It helps distinguish Legionella pneumonia from other similar diseases.

Legionella pneumonia treatment

Antibiotics

After clarifying the diagnosis, it is required to immediately begin treatment for legionella pneumonia. I need hospitalization in the infectious diseases department. The causative agents of Legionella pneumonia are found in the extracellular space. This feature makes it difficult for many drugs to act on them. Funds are used that are able to freely penetrate and accumulate in bronchial secretions. These are antibiotics of the macrolide and fluoroquinolone group. In case of a serious condition of the patient, drugs are administered through a dropper. Legionellosis is difficult to treat and can last up to three weeks.

Other methods of therapy are aimed at reducing symptoms, alleviating the condition of a sick person. It is necessary to reduce the manifestations of intoxication, restore the respiratory function, and normalize the work of the digestive system. Renal failure is treated with diuretics and hemodialysis is performed if necessary.

After discharge, the patient is under medical supervision. Vaccination is postponed for the child. An examination should be carried out 4 times a year to identify complications after legionella pneumonia.

Pathological anatomy shows that one of the consequences of legionella pneumonia is a decrease in lung volume, rapid breathing.

Preventive measures

No definitive measures have been taken to prevent the spread of Legionella bacteria. Epidemics of this type of pneumonia begin when pathogens multiply in closed sewers, humidifiers, air conditioners, and ventilation. If these systems are regularly, promptly cleaned, processed, microorganisms will not be able to spread in large numbers. To stop the nosocomial development of pathology, it is necessary to carry out maintenance of the support systems. To prevent out-of-hospital spread of infection, you should disinfect the systems yourself. 

Ultraviolet water disinfection

Thermal methods are used to combat legionella, they die already at 80 ° C and chemical (chlorine-based preparations). Twice a year, the forced ventilation system is flushed and cleaned at enterprises, institutions, and common areas. When pathogenic pathogens are identified, the treatment is repeated every quarter.

Modern chemical and physical means of cleansing are being introduced. Ultraviolet irradiation of water, its enrichment with silver and copper ions is used. All of these methods reduce the harm that disinfection causes to plumbing and ventilation systems. There is no vaccination against Legionella pneumonia.

Good results are obtained by preventing lung infection in persons who are at risk:

• smokers with experience;
• patients undergoing treatment with immunosuppressants, hormones;
• persons with drug and alcohol addiction;
• adults over 40.

Legionnaires’ pneumonia is a serious illness that is difficult to detect and treat. It is especially important to timely identify the pathology. You should devote enough time to your health. The threat of infection comes from devices that are designed to bring comfort to a person (air conditioners, humidifiers, sewage, ventilation). These systems need regular care to prevent the appearance of pathogenic microorganisms.