Legionellosis, (Legionnaire Disease) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Legionellosis, Diagnosis and Treatment and Related Diseases
I always thought that Legionnaire’s Disease is a French disease because of the word Legionnaire but it is not related to France but the Legionella bacteria that like to grow in wet places.
The bacterium causing the illness among people attending a convention of the American Legion was named Legionella pneumophila and the name of the illness was changed to Legionellosis.

Legionellosis (Legionnaire's Disease) is an infection of the lungs and airways produced by Legionella bacteria
Legionellosis (Legionnaire's Disease) can produce a type of atypical pneumonia.
Signs and symptoms are cough, shortness of breath, high fever, muscle pains, and headaches.
This often begins two to ten days after exposure.
The bacterium is found naturally in fresh water.
It can pollute hot water tanks, hot tubs, and cooling towers of large air conditioners.
It is normally spread by breathing in mist that contains the bacteria.
It normally does not spread directly between people and most people who are exposed do not become infected.
The patient gets the infection by breathing in droplets of water which contain legionella germs (bacteria) from contaminated water systems
Pontiac fever is a mild infection also caused by legionella normally without pneumonia formation
Cause:
Legionnaires' disease is normally spread by the breathing in of aerosolized water and soil contaminated with the Legionella bacteria
The bacteria grow best at warm temperatures between 25 and 45 C (77 and 113 F), with an optimum temperature of 35 C (95 F).
Temperatures above 60 C (140 F) kill it.
Sources where temperatures allow the bacteria to thrive are hot water tanks, cooling towers, and evaporative condensers of large air conditioning systems, such as those often found in hotels and large office buildings
Symptoms:

Symptoms tend to get worse during the first 4 - 6 days.

They most often improve in another 4 - 5 days.

Symptoms start off with:
1.Sudden onset of malaise
2.High fever 39-40 C
3.Chills, rigors
4.Headache
5.Dry coughs
Diagnosis:
Diagnosis is by a blood and urinary antigen test and sputum culture.
Chest x-ray shows patchy consolidation and evidence of pneumonia
Indirect legionna bacterial antibody is higher than 1.256
Treatment:
Treatment is started with antibiotics as soon as possible.
Normally they are given intravenously (IV) which means into a vein
IV fluids are often given to keep the patient well hydrated
Delay in giving the proper antibiotic leads to higher mortality.
Recommended antibiotics are fluoroquinolones, azithromycin, or doxycycline.
Isolation in hospital is not necessary.
Pulmonary care -nebulizer, oxygen, deep breathing exercises, steam inhalation, cough mixture
The most successful antibiotics are most macrolides, tetracyclines, ketolides, and quinolones
Macrolides (azithromycin) are given in all age groups, while tetracyclines (doxycycline) are given for children above the age of 12 and quinolones (levofloxacin) above the age of 18
Rifampicin can be used in combination with a quinolone or macrolide
Patients with moderate or mild pneumonia in whom Legionnaires’ disease is suspected on strong grounds or in whom a rapid positive diagnosis has been achieved using urinary legionella antigen assays may be switched to better agents if they are failing to improve on initial therapy.
Patients on older macrolides and β-lactams may be switched to azithromycin or quinolones.
Initial, empirical therapy increasingly is azithromyin or quinolones for hospitalized patients with suspected legionellosis.
Intensive care with supportive treatments such as assisted ventilation may be needed if the pneumonia is severe.

TABLE OF CONTENT
Introduction
Chapter 1 Legionellosis
Chapter 2 Causes
C

• Language: English
• Publisher: Kenneth Kee
• Release date: May 15, 2018
• ISBN: 9780463560532

Kenneth Kee

Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 70. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com This autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 1000 eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical disorders. He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Buona Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. The entire PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"

Book preview

Legionellosis,

(Legionnaire Disease)

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2018 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Legionnaire’s Disease, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Legionnaire’s Disease)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Legionellosis (Legionnaire Disease)

I always thought that Legionnaire Disease is a French disease due to the word Legionnaire but it is not related to France but the Legionella bacteria that like to grow in wet places.

The bacterium causing the illness among people attending a convention of the American Legion was named Legionella pneumophila and the name of the illness was changed to Legionellosis.

What is Legionellosis (Legionnaire Disease)?

Legionellosis (Legionnaire Disease) is an infection of the lungs and airways produced by Legionella bacteria.

Legionellosis is an acute, infectious disease of the respiratory tract caused by the bacillus Legionella pneumophilia, a Gram negative, non-sporulating aerobic micro-organism.

Legionnaire disease can produce a type of atypical pneumonia.

Signs and symptoms include cough, shortness of breath, high fever, muscle pains, and headaches.

Nausea, vomiting, and diarrhea may also occur.

This often begins two to ten days after exposure.

The bacterium is found naturally in fresh water.

It can pollute hot water tanks, hot tubs, and cooling towers of large air conditioners.

It is normally spread by breathing in mist that contains the bacteria.

It can also happen when contaminated water is aspirated.

It normally does not spread directly between people and most people who are exposed do not become infected.

It is advised that those with severe pneumonia and those with pneumonia and a recent travel history be tested for the disease.

Legionnaire disease is a serious lung disease (pneumonia) with chills, high temperature (fever) and muscle pains.

The patient gets the infection by breathing in droplets of water which contain legionella germs (bacteria) from contaminated water systems.

The earlier the illness is treated with antibiotic medication, the better the likely outcome.

The illness is serious and can be fatal, but it is not contagious (it cannot be passed from person to person).

Pontiac fever is a milder illness caused by the same bacterium.

What are Legionnaire disease and Pontiac fever?

Legionellosis is a rare infection caused by a bacterium called legionella.

There are 2 types of illness which can result after being infected with this bacterium:

1. Legionnaire disease.

This causes a lung infection (pneumonia).

It is normally a severe illness which is occasionally fatal.

2. Pontiac fever.

This happens when the bacteria cause a flu-like illness.

It is not normally serious.

Legionella bacteria

Legionella bacteria grow in fresh water and mud and are found all over the world.

Most cases of illness are produced