Drbeen Forum | drbeen

Want to ask a question or post a comment?

Sign In.

Back To Forum
Sign In

Microbiology - Legionella (UW and MMRS)
Mobeen Syed, MD - 2018-09-16 17:13:51

Not mentioned in FA.

Legionella presents with high fever and low pulse/bradycardia (pulse-fever dissociation.)

For example 102F with 75 bpm pulse.

Microbiology - Legionella (UW and MMRS)
Mobeen Syed, MD - 2018-09-16 17:16:39

Clues to increase the index of legionella suspicion

Exposure

  • Recent travel (especially cruise or hotel stay). Exposure to possibly contaminated water within the previous 2 weeks

  • Contaminated potable water in hospitals/nursing homes

Clinical

  • Fever >39 C (102.2 F)

  • Bradycardia relative to high fever

  • Neurological symptoms (especially confusion)

  • Gastrointestinal symptoms (especially diarrhea)

  • Unresponsive to beta-lactam & aminoglycoside antibiotics

Lab clues

  • Hyponatremia

  • Hepatic dysfunction

  • Hematuria & proteinuria

  • Sputum Gram stain showing many neutrophils, but few or no microorganisms

Report Reply