Description of legionnaires’ disease
1976 in the United States in Philadelphia hosted a conference of war veterans – legionnaires. After some time of the congress most of the participants became ill severe pneumonia, which some have even succumbed. Because they were so numerous and sudden onset of severe pneumonia suspect – sickened many people at once (those who resided in the same areas), began to look for the cause. In the air conditioner the hotel where they were staying legionaries were eventually discovered in the meantime still unwritten bacterium was named Legionella pneumophila and severe form of pneumonia caused by Legionnaires’ disease.
Originators of the disease – Legionella in nature around us normally occur. Their natural habitat is mainly natural water sources such as rivers, lakes and other possible water reservoirs which often serve as a source of drinking water. From therefore Legionella get into human settlements (which does not mean that every time you shoot water from the tap, get Legionnaires’ disease. Because of this possible route of infection knows they are in drinking water adhered to strict rules designed to prevent this)
Legionella is a bacterium that for its growth requires a certain comfort. It’s especially water temperature – it must be between 20-45 ° C. If the water temperature is higher, legionella perishes, if lower, do not reproduce, but can “sleep” and wake up to the moment when the water temperature rises again. Furthermore he likes enough nutrients and in particular the presence of certain metals such as iron, copper and zinc. That’s why she was doing so well in air conditioners and water pipes.
In human organism legionella receives first, ingestion of contaminated water or by inhalation of infectious aerosols, which is formed in air conditioning systems. The smaller the aerosol droplets, the deeper into the airways with legionella gets and the more dangerous form of the disease can cause.
Besides hardest forms of the disease – Legionnaires’ disease – which is pneumonia, it describes also a second form and the so-called. Pontiac fever (by Pontiac which occurred outbreak of the disease). It is the nature of the disease flu that has such a difficult course as legionnaires’ disease.Furthermore, it is also possible that, although Legionella infect, disease you ever arise – with sufficiently strong immune system which prevents the disease in time.
There are many different species of Legionella, but not all can cause disease in humans. Also not shown that it could infect from person to person.
Risk factors for Legionnaires’ disease
As with all other diseases plays an important role in immune status – hence legionellosis risk elderly people whose immune system is weaker, people suffering from some chronic disease which their immune system is depleted and people whose immunity is even therapeutically weakened as in the case of organ transplants.
Another very important risk factor is smoking. It is probably also the reason why men are more at risk than women. Men – smokers had more than women – smokers, although in recent years of women smokers is increasing considerably.
Prevention of Legionnaires’ disease
As risk factors apparent prevention of maintaining good condition of the immune system – thus receiving sufficiently balanced diet that contains vitamins and trace elements, get enough sleep and avoiding stress.
And, of course, maintaining physical fitness.
To protect the water supply system by a technical directive which describes the procedures leading to the control and prevention of legionella in water systems.
Symptoms of Legionnaires’ disease
There are two forms of disease which induces legionella:
Legionnaires’ disease
After an incubation period of 2-10 days (period from penetration of bacteria into the body after the development of symptoms) develops an image of acute pneumonia. The patient is lethargic, has a fever and headache (headache), it foundered, coughing. The cough is initially dry without coughing up phlegm. There are chest pain. May be altered state of consciousness, the patient is confused, hallucinating. Often added abdominal pain, vomiting and diarrhea. As the disease progresses, it can also affect other organs – liver, kidneys, central nervous system (brain and spinal cord), digestive system. Rarely can occur pericarditis (pericarditis), and heart muscle (myocarditis).
Legionnaires’ disease is a serious disease that can be fatal sick, especially if they belong to risk groups.
Pontiac fever
It has a shorter incubation period of the disease develops within 48 hours of infection with legionella. Basically has the same symptoms as flu. Appears fever, chills, fever, headache and muscular pain, the patient is slack. The disease does not affect the lungs and to a few days after treatment timely adjusted.
Treatment of Legionnaires’ disease
It consists in the administration of antibiotics, which represent so. Causal therapy (heals itself cause disease – kills Legionella). In mild cases, given erythromycin or tetracycline, in patients with a weakened immune system and then hospitalized azithromycin and levofloxacin.
Furthermore, taking medication to relieve the symptoms that accompany the disease – analgesics (painkillers), antipyretic (against temperature) expaktorancia (on coughing), mykolytika (diluted mucus)
In the event that the patient’s condition is serious and they are endangered basic life functions, it is necessary to deploy intensive therapy and the patient often translate to an intensive care unit, where there are all the instruments and special drugs used to modify the function of the failing organ systems affected.
How to help treat Legionnaires’ disease
First, keep in good physical condition – healthy eating and regular, run physical activity, adequate sleep, avoiding stress.
If you smoke, stop. If you enjoy alcohol, limit their consumption to a minimum.
When signs of pneumonia can best help appropriately Central attacks antibiotic therapy – so visit your doctor. This therapy necessarily includes a regimen measures such as bed rest, plenty of rest, so that the body can easily heal faster.
Complications of legionnaires’ disease
Legionnaires’ disease is most commonly manifested as pneumonia, and so is outside the specific complications of the disease Legionella and the same complications.
It is a pleuritis – pleurisy, which manifests pain during breathing movements, therefore plytce patient breathes so much nerozpínaly chest and usually seeks position on the affected side, so it is less painful.
Further complications with pleurisy closely related – it is the presence of pus in the pleural cavity – or empyema. The basis of treatment of empyema is antibiotics and draining the pus drain.
In lung tissue also can create delimited cavity filled with pus – the abscess. If the lungs as a result of inflammation abscess develops, there will be worsening the already serious condition, present chest pain, shortness of breath, coughing up pus, in which it may contain blood, typical of the strong odor from the mouth. The patient has a high fever, is seized, it has chills and fever. An abscess may compromise the through the lungs into the pleural cavity and cause empyema.
The treatment involves administration of potent antibiotics if an abscess persists, accesses to itsdrainage (discharge). CT-guided abscess was drained and wiretaps. If deposited deep in the lungs, it can be omitted under endoscopic control (by inserting the optical device – of the endoscope that allows the interior of the bronchi).
Extrapulmonary symptoms are very different and it depends on which organ system is posižen.Often it is the liver and kidneys, resulting in their failure – these symptoms are mainly demonstrated in the laboratory – increases to optimize the concentrations of bilirubin, creatinine and blood urea nitrogen. Thus complicated legionnaires’ disease can lead to death.
Other names: Pontiac fever, pneumonia caused by Legionella pneumophila
