Clinical Information

Legionella pneumophila may cause pulmonary disease in normal and immunocompetent individuals. The disease may occur sporadically in the form of community acquired pneumonia or as an epidemic. Pneumonia (often referred to as Legionnaires disease) occurs more frequently in individuals who are severely immunosuppressed; a milder form of the illness, Pontiac fever, is more prevalent in normal hosts. Extrapulmonary infection with L pneumophila is rare. Legionnaires disease, Pontiac fever, and extrapulmonary infection have been collectively referred to as legionellosis.

Approximately 85% of the documented cases of legionellosis have been caused by L pneumophila. Serogroups 1 and 6 of L pneumophila, by themselves, account for up to 75% of cases of legionellosis.

The definitive diagnosis of L pneumophila is made by isolation of the organism on specialized culture medium (buffered charcoal yeast extract agar) or detection by a nucleic acid amplification test. In the absence of invasive procedures (eg, bronchial alveolar lavage), evaluation of patient urine samples for L pneumophila serotype 1 antigen may be useful. Testing for antibodies to L pneumophila may be helpful to establish prior exposure or infection, however, does not differentiate between acute and past infection.