Clinical Symptoms and Treatment of Legionellosis
Giancarlo Ceccarelli, Mario Venditti, Maria Scaturro and Maria Luisa Ricci
from: Legionellosis Diagnosis and Control in the Genomic Era (Edited by: Jacob Moran-Gilad and Rachel E. Gibbs). Caister Academic Press, U.K. (2020) Pages: 173-186.
Legionellosis causes a unique clinical course which can pose challenges for prompt diagnosis and treatment. This chapter discusses the clinical symptoms of the two forms of legionellosis, Legionnaires' disease and Pontiac fever, along with the current antibiotic treatment regimens for Legionnaires' disease. Legionella pneumonia does not have clear distinguishing features apart from other cases of bacterial pneumonia. Clinical scores and predicting tools have been developed to predict the likelihood of Legionella infection and determine the severity of infection. Antibiotics effective against Legionella must be active and concentrated in the intracellular space as well as distributed to infected tissues. Currently, fluoroquinolones and macrolides are the first line treatment with preference for fluoroquinolones and particularly, levofloxacin. However, immunocompromised patients may have unique clinical features requiring a more intensive antibiotic regimen. Lastly, the nonspecific symptoms of legionellosis may lead to misdiagnosis and treatment with antibiotics such as, beta-lactams which may cause a brief clinical improvement followed by a severe deterioration. Due to this dangerous phenomenon and the rise of antibiotic resistance, diagnosis and treatment regimens must be carefully considered read more ...