FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 337:682-687 September 4, 1997 Number 10 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Legionnaires' disease was first recognized during an outbreak of pneumonia involving delegates to the 1976 American Legion convention at a Philadelphia hotel. Full appreciation of its role other than as an exotic pathogen has only come in the past several years. As diagnostic methods have improved and epidemiologic understanding of its reservoir has been exploited, legionella has been found to be a common cause of community-acquired and nosocomial pneumonia. Many excellent reviews have been published,^1,2,3,4 so this review will focus on newer findings.

Epidemiology

Community-Acquired Pneumonia

Outbreaks of legionnaires' disease in hotels, cruise ships, and office buildings continue to garner media attention. The . . . [Full Text of this Article]

Nosocomial Pneumonia

Risk Factors

Pediatric Legionellosis

Mode of Transmission

Virulence

Clinical Manifestations

Laboratory Diagnosis

Therapy

Prevention

Source Information

From the Veterans Affairs Medical Center and the University of Pittsburgh, Pittsburgh.

Address reprint requests to Dr. Yu at the Infectious Diseases Section, VA Medical Center, University Dr. C, Pittsburgh, PA 15240.

References

Related Letters:

Legionnaires' Disease
Edelstein P. H., Yu V. L., Stout J. E.
Extract | Full Text  
N Engl J Med 1998; 338:200-201, Jan 15, 1998. Correspondence

This article has been cited by other articles:

• Lim, W S, Baudouin, S V, George, R C, Hill, A T, Jamieson, C, Le Jeune, I, Macfarlane, J T, Read, R C, Roberts, H J, Levy, M L, Wani, M, Woodhead, M A, Pneumonia Guidelines Committee of the BTS Standard, (2009). BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax 64: iii1-iii55 [Full Text]  
• van der Eerden, M. M., Boersma, W. G. (2009). Impact of macrolide therapy on mortality in severe sepsis caused by pneumonia. Eur Respir J 34: 521-521 [Full Text]  
• Sakamoto, R., Ohno, A., Nakahara, T., Satomura, K., Iwanaga, S., Saito, M., Okumiya, K., Yamaguchi, K. (2009). A patient with Legionnaires' disease transferred after a traffic accident. BMJ Case Reports 2009: bcr0920080893-bcr0920080893 [Abstract] [Full Text]  
• Ginevra, C., Lopez, M., Forey, F., Reyrolle, M., Meugnier, H., Vandenesch, F., Etienne, J., Jarraud, S., Molmeret, M. (2009). Evaluation of a Nested-PCR-Derived Sequence-Based Typing Method Applied Directly to Respiratory Samples from Patients with Legionnaires' Disease. J. Clin. Microbiol. 47: 981-987 [Abstract] [Full Text]  
• Choi, P., Qin, X., Chen, E. Y., Inglis, A. F. Jr, Ou, H. C., Perkins, J. A., Sie, K. C. Y., Patterson, K., Berry, S., Manning, S. C. (2009). Polymerase Chain Reaction for Pathogen Identification in Persistent Pediatric Cervical Lymphadenitis. Arch Otolaryngol Head Neck Surg 135: 243-248 [Abstract] [Full Text]  
• Karam, G. H. (2009). Infections in AIDS Patients and Other Immunocompromised Hosts. ACCP Crit Care Med Brd Rev 20: 13-40 [Full Text]  
• Naik, T. K., Stein, S., Kamangar, N. (2008). SPONTANEOUSLY RESOLVING CEREBRAL EDEMA IN A CASE OF LEGIONNAIRE'S DISEASE. Chest Meeting 134: c63002-c63002 [Abstract]  
• Bruns, A. H. W., Oosterheert, J. J., Hak, E., Hoepelman, A. I. M. (2008). Usefulness of consecutive C-reactive protein measurements in follow-up of severe community-acquired pneumonia. Eur Respir J 32: 726-732 [Abstract] [Full Text]  
• Vinzing, M., Eitel, J., Lippmann, J., Hocke, A. C., Zahlten, J., Slevogt, H., N'Guessan, P. D., Gunther, S., Schmeck, B., Hippenstiel, S., Flieger, A., Suttorp, N., Opitz, B. (2008). NAIP and Ipaf Control Legionella pneumophila Replication in Human Cells. J. Immunol. 180: 6808-6815 [Abstract] [Full Text]  
• Kumpers, P., Tiede, A., Kirschner, P., Girke, J., Ganser, A., Peest, D. (2008). Legionnaires' disease in immunocompromised patients: a case report of Legionella longbeachae pneumonia and review of the literature. J Med Microbiol 57: 384-387 [Abstract] [Full Text]  
• Vinh, D. C., Garceau, R., Martinez, G., Wiebe, D., Burdz, T., Reimer, A., Bernard, K. (2007). Legionella jordanis Lower Respiratory Tract Infection: Case Report and Review. J. Clin. Microbiol. 45: 2321-2323 [Abstract] [Full Text]  
• Nielsen, K., De Obaldia, A. L., Heitman, J. (2007). Cryptococcus neoformans Mates on Pigeon Guano: Implications for the Realized Ecological Niche and Globalization. Eukaryot Cell 6: 949-959 [Abstract] [Full Text]  
• Oosterheert, J. J., Bonten, M. J M, Schneider, M. M E, Buskens, E., Lammers, J.-W. J, Hustinx, W. M N, Kramer, M. H H, Prins, J. M, Slee, P. H T. J, Kaasjager, K., Hoepelman, A. I M (2006). Effectiveness of early switch from intravenous to oral antibiotics in severe community acquired pneumonia: multicentre randomised trial. BMJ 333: 1193-1193 [Abstract] [Full Text]  
• Wong, S., Pabbaraju, K., Burk, V. F., Broukhanski, G. C., Fox, J., Louie, T., Mah, M. W., Bernard, K., Tilley, P. A. G. (2006). Use of sequence-based typing for investigation of a case of nosocomial legionellosis.. J Med Microbiol 55: 1707-1710 [Abstract] [Full Text]  
• Newton, H. J., Sansom, F. M., Bennett-Wood, V., Hartland, E. L. (2006). Identification of Legionella pneumophila-Specific Genes by Genomic Subtractive Hybridization with Legionella micdadei and Identification of lpnE, a Gene Required for Efficient Host Cell Entry. Infect. Immun. 74: 1683-1691 [Abstract] [Full Text]  
• Dirven, K., Ieven, M., Peeters, M. F, van der Zee, A., De Schrijver, K., Goossens, H. (2005). Comparison of three Legionella urinary antigen assays during an outbreak of legionellosis in Belgium. J Med Microbiol 54: 1213-1216 [Abstract] [Full Text]  
• Scaturro, M., Losardo, M., De Ponte, G., Ricci, M. L. (2005). Comparison of Three Molecular Methods Used for Subtyping of Legionella pneumophila Strains Isolated during an Epidemic of Legionellosis in Rome. J. Clin. Microbiol. 43: 5348-5350 [Abstract] [Full Text]  
• Sabria, M., Pedro-Botet, M. L., Gomez, J., Roig, J., Vilaseca, B., Sopena, N., Banos, V., for the Legionnaires Disease Therapy Group, (2005). Fluoroquinolones vs Macrolides in the Treatment of Legionnaires Disease. Chest 128: 1401-1405 [Abstract] [Full Text]  
• van der Eerden, M M, Vlaspolder, F, de Graaff, C S, Groot, T, Bronsveld, W, Jansen, H M, Boersma, W G (2005). Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study. Thorax 60: 672-678 [Abstract] [Full Text]  
• Hawn, T. R., Verbon, A., Janer, M., Zhao, L. P., Beutler, B., Aderem, A. (2005). Toll-like receptor 4 polymorphisms are associated with resistance to Legionnaires' disease. Proc. Natl. Acad. Sci. USA 102: 2487-2489 [Abstract] [Full Text]  
• Ngeh, J., Goodbourn, C. (2005). Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila in Elderly Patients With Stroke (C-PEPS, M-PEPS, L-PEPS): A Case-Control Study on the Infectious Burden of Atypical Respiratory Pathogens in Elderly Patients With Acute Cerebrovascular Disease. Stroke 36: 259-265 [Abstract] [Full Text]  
• Garbino, J, Bornand, J-E, Uckay, I, Fonseca, S, Sax, H (2004). Impact of positive legionella urinary antigen test on patient management and improvement of antibiotic use. J. Clin. Pathol. 57: 1302-1305 [Abstract] [Full Text]  
• Yu, V. L., Greenberg, R. N., Zadeikis, N., Stout, J. E., Khashab, M. M., Olson, W. H., Tennenberg, A. M. (2004). Levofloxacin Efficacy in the Treatment of Community-Acquired Legionellosis. Chest 125: 2135-2139 [Abstract] [Full Text]  
• File, T. M. Jr, Garau, J., Blasi, F., Chidiac, C., Klugman, K., Lode, H., Lonks, J. R., Mandell, L., Ramirez, J., Yu, V. (2004). Guidelines for Empiric Antimicrobial Prescribing in Community-Acquired Pneumonia. Chest 125: 1888-1901 [Abstract] [Full Text]  
• Greub, G., Raoult, D. (2004). Microorganisms Resistant to Free-Living Amoebae. Clin. Microbiol. Rev. 17: 413-433 [Abstract] [Full Text]  
• Jain, P., Sandur, S., Meli, Y., Arroliga, A. C., Stoller, J. K., Mehta, A. C. (2004). Role of Flexible Bronchoscopy in Immunocompromised Patients With Lung Infiltrates. Chest 125: 712-722 [Abstract] [Full Text]  
• Hawn, T. R., Verbon, A., Lettinga, K. D., Zhao, L. P., Li, S. S., Laws, R. J., Skerrett, S. J., Beutler, B., Schroeder, L., Nachman, A., Ozinsky, A., Smith, K. D., Aderem, A. (2003). A Common Dominant TLR5 Stop Codon Polymorphism Abolishes Flagellin Signaling and Is Associated with Susceptibility to Legionnaires' Disease. JEM 198: 1563-1572 [Abstract] [Full Text]  
• Khamis, A., Colson, P., Raoult, D., Scola, B. L. (2003). Usefulness of rpoB Gene Sequencing for Identification of Afipia and Bosea Species, Including a Strategy for Choosing Discriminative Partial Sequences. Appl. Environ. Microbiol. 69: 6740-6749 [Abstract] [Full Text]  
• Kim, M. J., Sohn, J. W., Park, D. W., Park, S. C., Chun, B. C. (2003). Characterization of a Lipoprotein Common to Legionella Species as a Urinary Broad-Spectrum Antigen for Diagnosis of Legionnaires' Disease. J. Clin. Microbiol. 41: 2974-2979 [Abstract] [Full Text]  
• Che, D, Decludt, B, Campese, C, Desenclos, J C (2003). Sporadic cases of community acquired legionnaires' disease: an ecological study to identify new sources of contamination. J. Epidemiol. Community Health 57: 466-469 [Abstract] [Full Text]  
• Waxman, A. B., Shepard, J.-A. O., Mark, E. J. (2003). Case 14-2003 - A 73-Year-Old Woman with Pneumonia and Progressive Respiratory Failure. NEJM 348: 1902-1912 [Full Text]  
• Wever, P. C., Notermans, D. W., Tulevski, I. I., Eeftinck Schattenkerk, J. K. M., Jong, M. D. d. (2003). Detection of Legionella pneumophila Serogroup 1 Antigen in Bronchoalveolar Lavage Fluid by an Immunochromatographic Assay. J. Clin. Microbiol. 41: 2265-2265 [Full Text]  
• Wattanathum, A., Chaoprasong, C., Nunthapisud, P., Chantaratchada, S., Limpairojn, N., Jatakanon, A., Chanthadisai, N. (2003). Community-Acquired Pneumonia in Southeast Asia: The Microbial Differences Between Ambulatory and Hospitalized Patients. Chest 123: 1512-1519 [Abstract] [Full Text]  
• Aoki, S., Hirakata, Y., Miyazaki, Y., Izumikawa, K., Yanagihara, K., Tomono, K., Yamada, Y., Tashiro, T., Kohno, S., Kamihira, S. (2003). Detection of Legionella DNA by PCR of whole-blood samples in a mouse model. J Med Microbiol 52: 325-329 [Abstract] [Full Text]  
• Carroll, K. C. (2002). Laboratory Diagnosis of Lower Respiratory Tract Infections: Controversy and Conundrums. J. Clin. Microbiol. 40: 3115-3120 [Full Text]  
• Fields, B. S., Benson, R. F., Besser, R. E. (2002). Legionella and Legionnaires' Disease: 25 Years of Investigation. Clin. Microbiol. Rev. 15: 506-526 [Abstract] [Full Text]  
• Danes, C., Gonzalez-Martin, J., Pumarola, T., Rano, A., Benito, N., Torres, A., Moreno, A., Rovira, M., Puig de la Bellacasa, J. (2002). Pulmonary Infiltrates in Immunosuppressed Patients: Analysis of a Diagnostic Protocol. J. Clin. Microbiol. 40: 2134-2140 [Abstract] [Full Text]  
• (2001). BTS Guidelines for the Management of Community Acquired Pneumonia in Adults. Thorax 56: iv1-64 [Full Text]  
• Yawetz, S., Mark, E. J. (2001). Case 37-2001- A 76-Year-Old Man with Fever, Dyspnea, Pulmonary Infiltrates, Pleural Effusions, and Confusion. NEJM 345: 1627-1634 [Full Text]  
• Deng, J. C., Tateda, K., Zeng, X., Standiford, T. J. (2001). Transient Transgenic Expression of Gamma Interferon Promotes Legionella pneumophila Clearance in Immunocompetent Hosts. Infect. Immun. 69: 6382-6390 [Abstract] [Full Text]  
• Gupta, S. K., Imperiale, T. F., Sarosi, G. A. (2001). Evaluation of the Winthrop-University Hospital Criteria to Identify Legionella Pneumonia. Chest 120: 1064-1071 [Abstract] [Full Text]  
• Brouqui, P., Raoult, D. (2001). Endocarditis Due to Rare and Fastidious Bacteria. Clin. Microbiol. Rev. 14: 177-207 [Abstract] [Full Text]  
• La Scola, B., Mezi, L., Weiller, P. J., Raoult, D. (2001). Isolation of Legionella anisa Using an Amoebic Coculture Procedure. J. Clin. Microbiol. 39: 365-366 [Abstract] [Full Text]  
• Weir, E. (2000). Coping with Legionella. CMAJ 163: 1336-1336 [Full Text]  
• Wever, P. C., Yzerman, E. P. F., Kuijper, E. J., Speelman, P., Dankert, J. (2000). Rapid Diagnosis of Legionnaires' Disease Using an Immunochromatographic Assay for Legionella pneumophila Serogroup 1 Antigen in Urine during an Outbreak in The Netherlands. J. Clin. Microbiol. 38: 2738-2739 [Abstract] [Full Text]  
• Shapiro, D. S., Mark, E. J. (2000). Case 14-2000- A 60-Year-Old Farm Worker with Bilateral Pneumonia. NEJM 342: 1430-1438 [Full Text]  
• Tan, M. J., Tan, J. S., Hamor, R. H., File, T. M. Jr., Breiman, R. F. (2000). The Radiologic Manifestations of Legionnaire’s Disease. Chest 117: 398-403 [Abstract] [Full Text]  
• Visca, P., Goldoni, P., Lück, P. C., Helbig, J. H., Cattani, L., Giltri, G., Bramati, S., Pastoris, M. C. (1999). Multiple Types of Legionella pneumophila Serogroup 6 in a Hospital Heated-Water System Associated with Sporadic Infections. J. Clin. Microbiol. 37: 2189-2196 [Abstract] [Full Text]  
• La Scola, B., Michel, G., Raoult, D. (1999). Isolation of Legionella pneumophila by Centrifugation of Shell Vial Cell Cultures from Multiple Liver and Lung Abscesses. J. Clin. Microbiol. 37: 785-787 [Abstract] [Full Text]  
• Domínguez, J. A., Galí, N., Pedroso, P., Fargas, A., Padilla, E., Manterola, J. M., Matas, L. (1998). Comparison of the Binax Legionella Urinary Antigen Enzyme Immunoassay (EIA) with the Biotest Legionella Urin Antigen EIA for Detection of Legionella Antigen in both Concentrated and Nonconcentrated Urine Samples. J. Clin. Microbiol. 36: 2718-2722 [Abstract] [Full Text]  
• Schülin, T., Wennersten, C. B., Ferraro, M. J., Moellering, R. C. Jr., Eliopoulos, G. M. (1998). Susceptibilities of Legionella spp. to Newer Antimicrobials In Vitro. Antimicrob. Agents Chemother. 42: 1520-1523 [Abstract] [Full Text]  
• Edelstein, P. H., Yu, V. L., Stout, J. E. (1998). Legionnaires' Disease. NEJM 338: 200-201 [Full Text]