Rzeszow on target for Legionella pneumophila

Legionella lives in natural and artificial bodies of water, plumbing, taps and strainers of faucets and showers, air conditioning /work, entertainment/vehicles/, humidification equipment, whirlpools, thermal pools, spa pools, medical devices.

Massacre! I've listed all the things I love most during the hot weather.

The disease historically known as legionellosis is a severe respiratory illness that attacks the lungs.

The bacterium multiplies inside alveolar macrophages and blood monocytes.

Plumbers and tourists /India/ are sometimes a group prone to infections.

The disease is not transmitted by drinking contaminated water.

The disease is transmitted by inhalation of water aerosol, e.g., through curtains spraying water mist to, for example, cool or moistening the environment.

The incubation period is up to 14 days, but is sometimes considerably shorter in immunosuppressed individuals.

In its early stages, the disease with its symptoms resembles the flu / high temperature - fever above 39 degrees Celsius, dry cough, muscle pain, headache, chills/.

Later, the patient complains of chest pains, diarrhea, vomiting, blood in the stool, disturbance of consciousness, bradycardia is observed.

The severity of the listed symptoms depends on the patient's immune system.

In the extrapulmonary-rare form, there is an attack of the bacteria on parenchymal tissues and organs.

It is sometimes mistaken for the flu and is therefore probably not always correctly diagnosed.

Traditional risk factors for legionellosis include smoking, corticosteroid use and chronic lung disease, immunosuppressive drugs.

The following tests are helpful: microbiological and laboratory diagnostics.

We rely on traditional microbiological research:

a/ on identifying what will grow on the plates. We have to wait about 7-14 days for the results, and the disease, being self-limiting, can slow down after 2 or 3 weeks. Detects live all species of Legionella. Requires the skill of a microbiologist and great care in the work.

b/ PCR detects Legionella-specific DNA or RNA, live and dead bacteria cannot be distinguished, trouble is gene units of the result are not equivalent to CFU.

You need to ask for a conversion to choose antibiotic therapy.

But PCR results are useful for screening, and the result is known after a waiting time of 2 to 48 hours.

Laboratory diagnostic tests determine an increase in ALT, ASPAT and serum phosphocreatine kinase/creatine kinase activity, as well as hyponatremia, proteinuria or hematuria.

I suggest considering the following antibiotics unless local experience such as resistance, clinical practice, and concurrent colonization of the patient with other pathogens say otherwise.

Levofloxacin i.v. or p.o. 500 mg 1-2 × daily

Ciprofloxacin i.v. 400 mg 2 × day or p.o. 500 mg 2 × day.

moxifloxacin p.o. 400 mg 1 × dz.

Azithromycin 500 mg 1 × daily.

Clarithromycin 500 mg 2 × dz.

erythromycin 500 mg 4 × dz.

Doxycycline p.o. or i.v. starting dose 200 mg, then 100 mg 1 × day (2 × day in more severe infections).

We disinfect water in tanks and plumbing systems:

Chlorine, chloramine / monochloramine/ , ozone, chlorine dioxide, hypochlorites.

Dr. of Pharmaceutical Sciences Leszek Borkowski