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</div><div><span>Legionnaires disease</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Legionnaires disease</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Legionnaires disease is an infection of the lungs and airways. It is caused by <em>Legionella</em> bacteria.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>The bacteria that cause Legionnaires disease have been found in water delivery systems. They can survive in the warm, moist air conditioning systems of large buildings, including hospitals.</p><p>Most cases are caused by the bacteria <em>Legionella pneumophila</em>. The rest of the cases are caused by other <em>Legionella</em> species.</p><p>Spread of the bacteria from person to person has not been proven.</p><p>Most infections occur in middle-aged or older people. In rare cases, children can get the infection. When they do, the disease is less severe.</p><p>Risk factors include:</p><ul><li>Alcohol use</li><li>Cigarette smoking</li><li>Chronic illnesses, such as <a test="test" href="./000501.htm">kidney failure</a> or <a test="test" href="./001214.htm">diabetes</a></li><li>Long-term (chronic) lung disease, such as <a test="test" href="./000091.htm">COPD</a></li><li>Long-term use of a breathing machine (ventilator)</li><li>Medicines that suppress the immune system, including chemotherapy and steroid drugs</li><li>Older age </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms tend to get worse during the first 4 to 6 days. They most often improve in another 4 to 5 days.</p><p>Symptoms may include:</p><ul><li>General discomfort, loss of energy, or ill feeling (malaise)</li><li>Headache</li><li>Fever, shaking chills</li><li>Joint pain, muscle aches and stiffness</li><li>Chest pain</li><li>Cough that does not produce much sputum or mucus (dry cough)</li><li>Coughing up blood (rare)</li><li>Diarrhea, nausea, vomiting, and abdominal pain </li><li>Shortness of breath</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>The health care provider will perform a physical exam. Abnormal sounds, called crackles, may be heard when listening to the chest with a stethoscope.</p><p>Tests that may be done include:</p><ul><li><a test="test" href="./003855.htm">Arterial blood gases</a></li><li>Blood cultures or other tests to identify the bacteria</li><li><a test="test" href="./003857.htm">Bronchoscopy</a> to view the airways and diagnose lung disease</li><li><a test="test" href="./003804.htm">Chest x-ray</a> or <a test="test" href="./003788.htm">CT scan</a></li><li>Complete blood count (<a test="test" href="./003642.htm">CBC</a>), including <a test="test" href="./003643.htm">white blood cell count</a></li><li><a test="test" href="./003436.htm">Liver blood tests</a></li><li>Tests and cultures on sputum to identify <em>Legionella </em>bacteria</li><li>Urine tests to check for <em>Legionella pneumophila</em> bacteria</li><li>Molecular tests with polymerase chain reaction (PCR) </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Antibiotics are used to fight the infection. Treatment is started as soon as Legionnaire disease is suspected, without waiting for results of any lab test.</p><p>Other treatments may include receiving:</p><ul><li>Fluids through a vein (IV) </li><li>Oxygen, which is given through a mask or breathing machine</li><li>Medicines that are breathed in to ease breathing<br/><br/></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Legionnaires disease can be life threatening. The risk of dying is higher in people who:</p><ul><li>Have long-term (chronic) diseases or compromised immune systems</li><li>Become infected while in the hospital</li><li>Are older adults</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Contact your provider right away if you have any type of breathing problem and think you have symptoms of Legionnaires disease.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Legionella pneumonia; Pontiac fever; Legionellosis; Legionella pneumophila; Legionnaires' disease</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Patient Instructions</h2></div><div class="section-button"><button type="submit" aria-controls="section-carepnt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div name="Patient Instructions" class="section-body" id="section-carepnt"><ul class="side-nav"><li><a href="../patientinstructions/000017.htm">Pneumonia in adults - discharge</a></li>
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</ul></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1032t.jpg" alt="Legionnaire disease - organism legionella" title="Legionnaire disease - organism legionella" class="side-img"/><a href="../imagepages/1032.htm">Legionnaire disease - organism legionella</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Edelstein PH, Roy CR. Legionnaires' disease and Pontiac fever. In: Bennett JE, Dolin R, Blaser MJ, eds. <em>Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases</em>. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 232.</p><p>Marrie TJ. Legionella infections. In: Goldman L, Schafer AI, eds. <em>Goldman-Cecil Medicine</em>. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 298.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 1/22/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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