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Pneumonic and Nonpneumonic Forms of Legionellosis: The Result of a Common-Source Exposure to Legionella pneumophila

Pneumonic and Nonpneumonic Forms of Legionellosis: The Result of a Common-Source Exposure to... Abstract Two male maintenance workers contracted legionellosis while cleaning the interior of a cooling tower contaminated with Legionella pneumophila. In one man severe, life-threatening Legionnaires' disease developed, whereas the other experienced a comparatively mild, self-limited illness that was consistent with previous descriptions of cases of Pontiac fever. This report represents the first documentation of the development of both of these syndromes following exposure to a common source of the organism. The implications of this observation for the pathogenetic mechanisms that underly the different clinical manifestations of legionellosis are discussed. (Arch Intern Med 1982;142:545-547) References 1. McDade JE, Shepard CC, Fraser DW, et al: Legionnaires' disease: Isolation of a bacterium and demonstration of its role in other respiratory disease. N Engl J Med 1977;297:1197-1203.Crossref 2. Glick TH, Gregg MB, Berman B, et al: Pontiac fever: An epidemic of unknown etiology in a health department: I. Clinical and epidemiologic aspects. Am J Epidemiol 1978;107:149-160. 3. Fraser DW, Deubner DC, Hill DL, et al: Non-pneumonic, short-incubation-period legionellosis (Pontiac fever) in men who cleaned a steam turbine condenser. Science 1979;205:690-691.Crossref 4. Broome CV, Fraser DW: Epidemiologic aspects of legionellosis. Epidemiol Rev 1979;1:1-16. 5. England AC III, Fraser DW, Plikaytis BD, et al: Sporadic legionellosis in the United States: The first 1000 cases. Ann Intern Med 1981;94:164-170.Crossref 6. Winn WC, Cherry WB, Frank RO, et al: Direct immunofluorescent detection of Legionella pneumophila in respiratory specimens. J Clin Microbiol 1980;11:59-64. 7. Pasculle AW, Feeley JC, Gibson RJ, et al: Pittsburgh pneumonia agent: Direct isolation from human lung tissue. J Infect Dis 1980;141:727-732.Crossref 8. Tsai TF, Finn DR, Plikaytis BD, et al: Legionnaires' disease: Clinical features of the epidemic in Philadelphia. Ann Intern Med 1979;90:509-517.Crossref 9. Kirby BD, Snyder KM, Meyer RD, et al: Legionnaires' disease: Report of 65 nosocomially acquired cases and review of the literature. Medicine 1980;59:188-205.Crossref 10. Thacker SB, Bennett JV, Tsai TF, et al: An outbreak in 1965 of severe respiratory illness caused by the Legionnaires' disease bacterium. J Infect Dis 1978;138:512-519.Crossref 11. Terranova W, Cohen ML, Fraser DW: 1974 outbreak of Legionnaires' disease diagnosed in 1977: Clinical and epidemiologic features. Lancet 1978;2:122-124.Crossref 12. Marks JS, Tsai TF, Martone WJ, et al: Nosocomial Legionnaires' disease in Columbus, Ohio. Ann Intern Med 1979;90:565-568.Crossref 13. Beaty HN, Miller AA, Broome CV, et al: Legionnaires' disease in Vermont, May to October 1977. JAMA 1978;240:127-131.Crossref 14. Dondero TJ, Clegg HW II, Tsai TF, et al: Legionnaires' disease in Kingsport, Tennessee. Ann Intern Med 1979;90:569-573.Crossref 15. Politi BD, Fraser DW, Mallison GF, et al: A major focus of Legionnaires' disease in Bloomington, Indiana. Ann Intern Med 1979;90:587-591.Crossref 16. Cordes LG, Fraser DW, Skaliy P, et al: Legionnaires' disease outbreak at an Atlanta, Georgia country club: Evidence for spread from an evaporative condenser. Am J Epidemiol 1980;111:425-431. 17. Dondero TJ, Rendtorff RC, Mallison GF, et al: An outbreak of Legionnaires' disease associated with a contaminated air-conditioning cooling tower. N Engl J Med 1980;302:365-370.Crossref 18. Swartz MN: Clinical aspects of Legionnaires' disease. Ann Intern Med 1979;90:492-495.Crossref 19. Berendt RF, Young HW, Allen RG, et al: Dose-response of guinea pigs experimentally infected with aerosols of Legionella pneumophila. J Infect Dis 1980;141:186-192.Crossref 20. Miller RP: Cooling towers and evaporative condensers. Ann Intern Med 1979;90:667-670.Crossref 21. Landahl HD: The effect of gravity, hygroscopicity and particle size on the amount and site of deposition of inhaled particles , in Mercer TT, Morrow PE, Stober W (eds): Assessment of Airborne Particles . Springfield, Ill, Charles C Thomas Publisher, 1972, pp 421-428. 22. Druett HA, Robinson JM, Henderson DW, et al: Studies on respiratory infection: II. The influence of aerosol particle size on the infection of guinea pigs with P pestis. J Hyg 1956;54:37-48.Crossref 23. Johnston RF, Wildrick KH: The impact of chemotherapy on the care of patients with tuberculosis. Am Rev Respir Dis 1974;109:636-664. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Pneumonic and Nonpneumonic Forms of Legionellosis: The Result of a Common-Source Exposure to Legionella pneumophila

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340160125024
Publisher site
See Article on Publisher Site

Abstract

Abstract Two male maintenance workers contracted legionellosis while cleaning the interior of a cooling tower contaminated with Legionella pneumophila. In one man severe, life-threatening Legionnaires' disease developed, whereas the other experienced a comparatively mild, self-limited illness that was consistent with previous descriptions of cases of Pontiac fever. This report represents the first documentation of the development of both of these syndromes following exposure to a common source of the organism. The implications of this observation for the pathogenetic mechanisms that underly the different clinical manifestations of legionellosis are discussed. (Arch Intern Med 1982;142:545-547) References 1. McDade JE, Shepard CC, Fraser DW, et al: Legionnaires' disease: Isolation of a bacterium and demonstration of its role in other respiratory disease. N Engl J Med 1977;297:1197-1203.Crossref 2. Glick TH, Gregg MB, Berman B, et al: Pontiac fever: An epidemic of unknown etiology in a health department: I. Clinical and epidemiologic aspects. Am J Epidemiol 1978;107:149-160. 3. Fraser DW, Deubner DC, Hill DL, et al: Non-pneumonic, short-incubation-period legionellosis (Pontiac fever) in men who cleaned a steam turbine condenser. Science 1979;205:690-691.Crossref 4. Broome CV, Fraser DW: Epidemiologic aspects of legionellosis. Epidemiol Rev 1979;1:1-16. 5. England AC III, Fraser DW, Plikaytis BD, et al: Sporadic legionellosis in the United States: The first 1000 cases. Ann Intern Med 1981;94:164-170.Crossref 6. Winn WC, Cherry WB, Frank RO, et al: Direct immunofluorescent detection of Legionella pneumophila in respiratory specimens. J Clin Microbiol 1980;11:59-64. 7. Pasculle AW, Feeley JC, Gibson RJ, et al: Pittsburgh pneumonia agent: Direct isolation from human lung tissue. J Infect Dis 1980;141:727-732.Crossref 8. Tsai TF, Finn DR, Plikaytis BD, et al: Legionnaires' disease: Clinical features of the epidemic in Philadelphia. Ann Intern Med 1979;90:509-517.Crossref 9. Kirby BD, Snyder KM, Meyer RD, et al: Legionnaires' disease: Report of 65 nosocomially acquired cases and review of the literature. Medicine 1980;59:188-205.Crossref 10. Thacker SB, Bennett JV, Tsai TF, et al: An outbreak in 1965 of severe respiratory illness caused by the Legionnaires' disease bacterium. J Infect Dis 1978;138:512-519.Crossref 11. Terranova W, Cohen ML, Fraser DW: 1974 outbreak of Legionnaires' disease diagnosed in 1977: Clinical and epidemiologic features. Lancet 1978;2:122-124.Crossref 12. Marks JS, Tsai TF, Martone WJ, et al: Nosocomial Legionnaires' disease in Columbus, Ohio. Ann Intern Med 1979;90:565-568.Crossref 13. Beaty HN, Miller AA, Broome CV, et al: Legionnaires' disease in Vermont, May to October 1977. JAMA 1978;240:127-131.Crossref 14. Dondero TJ, Clegg HW II, Tsai TF, et al: Legionnaires' disease in Kingsport, Tennessee. Ann Intern Med 1979;90:569-573.Crossref 15. Politi BD, Fraser DW, Mallison GF, et al: A major focus of Legionnaires' disease in Bloomington, Indiana. Ann Intern Med 1979;90:587-591.Crossref 16. Cordes LG, Fraser DW, Skaliy P, et al: Legionnaires' disease outbreak at an Atlanta, Georgia country club: Evidence for spread from an evaporative condenser. Am J Epidemiol 1980;111:425-431. 17. Dondero TJ, Rendtorff RC, Mallison GF, et al: An outbreak of Legionnaires' disease associated with a contaminated air-conditioning cooling tower. N Engl J Med 1980;302:365-370.Crossref 18. Swartz MN: Clinical aspects of Legionnaires' disease. Ann Intern Med 1979;90:492-495.Crossref 19. Berendt RF, Young HW, Allen RG, et al: Dose-response of guinea pigs experimentally infected with aerosols of Legionella pneumophila. J Infect Dis 1980;141:186-192.Crossref 20. Miller RP: Cooling towers and evaporative condensers. Ann Intern Med 1979;90:667-670.Crossref 21. Landahl HD: The effect of gravity, hygroscopicity and particle size on the amount and site of deposition of inhaled particles , in Mercer TT, Morrow PE, Stober W (eds): Assessment of Airborne Particles . Springfield, Ill, Charles C Thomas Publisher, 1972, pp 421-428. 22. Druett HA, Robinson JM, Henderson DW, et al: Studies on respiratory infection: II. The influence of aerosol particle size on the infection of guinea pigs with P pestis. J Hyg 1956;54:37-48.Crossref 23. Johnston RF, Wildrick KH: The impact of chemotherapy on the care of patients with tuberculosis. Am Rev Respir Dis 1974;109:636-664.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1982

References