Abstract
Introduction: The Legionellaceae are fastidious Gram‐negative bacteria that reside in aquatic environments. They are a cause of severe community acquired pneumonia. Legionella pneumophila serogroup 1 is responsible for 70–90 % of human infection, with cases caused by some of the other 15 serogroups accounting for the rest. Most hospitals use the Legionella urinary antigen test for detection of legionellosis; however, this will only reliably detect L. pneumophila serogroup 1. Case presentation: We report two cases of severe community acquired pneumonia in patients requiring extracorporeal membrane oxygenation, referred to our adult Severe Respiratory Failure Unit. Legionella urinary antigen was negative in both cases. As clinical presentation strongly suggested Legionnaires’ disease (LD), respiratory samples were sent to the reference laboratory for PCR, which confirmed L. pneumophila non‐serogroup 1 in both cases. Case 1 was subsequently confirmed by culture and confirmed as L. pneumophila serogroup 5. Case 2 was culture‐negative. Conclusion: Legionella is an important pathogen. Recognition of the potential for non‐serogroup 1 strains to cause severe LD should prompt requests for further investigations including Legionella PCR in patients who present with suggestive symptoms when the urine antigen is negative. Reliance on the urine antigen test may result in a potentially serious under‐recognition of L. pneumophila non‐serogroup 1 and lead to mis‐diagnoses and inappropriate antimicrobial treatment.
Highlights
Of the 306 confirmed cases of Legionnaires’ disease, 168 (54.9%) cases were considered to have been exposed to the infecting organism in the community, 127(41.5%) cases were associated with travel abroad and 11 (3.6%) were considered to have links to a healthcare facility
Legionnaires’ disease is a severe but uncommon form of pneumonia associated with exposure to water systems colonised by legionella bacteria
The data presented in this report are collected by local Health Protection Teams (HPTs) in Public Health England Centres, collated and verified by the National Surveillance Scheme for Legionnaires’ disease, managed at Public Health England (PHE), Centre for Infectious Disease Surveillance and Control (CIDSC), Colindale, London
Summary
Public Health England’s mission is to protect and improve the nation’s health and to address inequalities through working with national and local government, the NHS, industry and the voluntary and community sector. PHE is an operationally autonomous executive agency of the Department of Health.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.