·Patients who have failed outpatient antibiotic therapy
·Patients with severe pneumonia, in particular those requiring intensive care
·Immuno-compromised host with pneumonia
·Patients with pneumonia in the setting of a legionellosis outbreak
·Patients with a travel history [Patients that have traveled away from their home within two weeks before the onset of illness.]
·Patients suspected of healthcare-associated pneumonia
RISK FACTORS:
Not everyone exposed to legionella bacteria becomes sick. You’re more likely to develop the infection if you:
·Smoke. Smoking damages the lungs, making you more susceptible to all types of lung infections.
·Have a weakened immune system as a result of HIV/AIDS or certain medications, especially corticosteroids and drugs taken to prevent organ rejection after a transplant.
·Have a chronic lung disease such as emphysema or another serious condition such as diabetes, kidney disease or cancer.
·Are 50 years of age or older.
Legionnaires’ disease is a sporadic and local problem in hospitals and nursing homes, where germs may spread easily and people are vulnerable to infection.
COMPLICATIONS:
Legionnaires’ disease can lead to a number of life-threatening complications, including:
·Respiratory failure. This occurs when the lungs are no longer able to provide the body with enough oxygen or can’t remove enough carbon dioxide from the blood.
·Septic shock. This occurs when a severe, sudden drop in blood pressure reduces blood flow to vital organs, especially to the kidneys and brain. The heart tries to compensate by increasing the volume of blood pumped, but the extra workload eventually weakens the heart and reduces blood flow even further.
·Acute kidney failure. This is the sudden loss of your kidneys’ ability to perform their main function — filtering waste material from your blood. When your kidneys fail, dangerous levels of fluid and waste accumulate in your body.
When not treated effectively and promptly, Legionnaires’ disease may be fatal, especially if your immune system is weakened by disease or medications.
You’re likely to start by seeing your family doctor or a primary care provider. However, in some cases, you may be referred to a doctor who specializes in treating lung disease (pulmonologist) or infectious diseases, or you may be advised to go to an emergency department.
