Presentation
Furthermore, Legionella meningoencephalitis may present with findings on magnetic resonance imaging previously thought to be characteristic of herpes encephalitis. [ncbi.nlm.nih.gov]
[…] a low-grade fever is usually present. [aafp.org]
[…] and laboratory studies Differential Mycoplasma pneumoniae distinguishing factor typically does not present with gastrointestinal or central nervous system involvement Treatment Medical antibiotics indication all patients drugs macrolides respiratory [step1.medbullets.com]
Case presentation A 43 year-old HIV positive man presented to our hospital with dysarthria, fevers, headache, and altered mental status. [bmcinfectdis.biomedcentral.com]
Entire Body System
- Fever
Brain Abscess, fever Fever Fever is defined as a measured body temperature of at least 38°C (100.4°F). Fever is caused by circulating endogenous and/or exogenous pyrogens that increase levels of prostaglandin E2 in the hypothalamus. [lecturio.com]
R Rabies Rabies Fact Sheet Rare Disease Task Force Report Raw Milk Reflex Sympathetic Dystrophy Syndrome (RSDS) Reproductive Health Respiratory Syncytial Virus (RSV) Ricin Rift Valley Fever Rocky Mountain Spotted Fever Rubella (German Measles) S Saint [health.pa.gov]
The second disease is Pontiac fever. Pontiac fever is a milder respiratory illness without pneumonia. Symptoms of Pontiac fever usually start about 24 to 72 hours after exposure. [protect.iu.edu]
Pontiac Fever Legionnaires' disease Pontiac fever Clinical Features Pneumonia: cough, fever, chest pain Flu-like illness (fever, chills, malaise) without pneumonia Radiographic pneumonia Yes No Incubation period 2-14 days after exposure 24-48 hours after [physio-pedia.com]
- Chills
Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. Fever, chills Chills The sudden sensation of being cold. It may be accompanied by shivering. [lecturio.com]
The non-pneumonic illness – also known as Pontiac Fever – includes flu-like symptoms such as fever, headache, malaise, chills, and muscle pain. [iamat.org]
Other symptoms may include a high fever, chills, myalgia, muscle aches, and/or headache. Abdominal pain, nausea, vomiting, and diarrhea are also common, and some people may have confusion or other mental changes. [dshs.texas.gov]
Symptoms Symptoms of Legionellosis include: Fever Chills Lack of energy Cough Muscle aches Headache Loss of appetite Diarrhea and/or vomiting Transmission Legionellosis infection is transmitted when a person breathes water droplets from the air (i.e., [protect.iu.edu]
Symptoms usually start within 5 to 6 days (can be from 2 to 10 days, and rarely as long as 3 weeks) after contact with the bacteria and include fever and chills, muscle aches, headache, cough, shortness of breath, weakness, diarrhea, loss of appetite [ottawapublichealth.ca]
- Malaise
The non-pneumonic illness – also known as Pontiac Fever – includes flu-like symptoms such as fever, headache, malaise, chills, and muscle pain. [iamat.org]
[…] headache malaise Physical exam fever Legionnaires disease altered mental status dyspnea relative bradycardia pneumonia Imaging Chest radiography indication all patients findings lobar consolidation or diffuse patchy infiltrates Studies Labs urine antigen [step1.medbullets.com]
We describe a case of pneumonia caused by C. pneumoniae and associated with meningoencephalitis.An 18-year-old man who had been in good health had malaise, a high temperature, and a nonproductive cough. [nejm.org]
Symptoms may include fever, headache, malaise, and muscle aches. [dshs.texas.gov]
Constitutional symptoms, which usually are present, include headache exacerbated by a cough, malaise, myalgias, and sore throat. The cough is usually dry, paroxysmal, and worse at night. [aafp.org]
- Weakness
Those most at risk of developing life-threatening infections are adults over 65, persons who smoke or are heavy alcohol users, and those who have lung disease, kidney disease, weak immune systems, or diabetes. [ottawapublichealth.ca]
People of any age may be infected, but the disease is more common in middle aged and older people and people whose immune system is weak. Men are affected more frequently than women. [sahealth.sa.gov.au]
People most at risk of getting sick from the bacteria are older people (usually 65 years or older), people who smoke or have chronic lung disease (like emphysema), and those who have weak immune systems from cancer, diabetes, kidney failure, medications [doh.wa.gov]
People at high risk of serious illness include those over 50 years of age, people who smoke cigarettes and people with a weak immune system e.g. those with a chronic medical condition such as lung disease, kidney disease, diabetes, cancer or HIV. [conditions.health.qld.gov.au]
Patient Care: Respiratory Therapists/PTs: O2 therapy, repositioning, postural drainage, suctioning Monitor: Chest wall expansion, depth/pattern of ventilations, cough, chest pain, restlessness, & hypoxemia Signs of Shock: ↓ blood pressure, tachycardia w/weak [physio-pedia.com]
- Rigor
Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. Fever, chills Chills The sudden sensation of being cold. It may be accompanied by shivering. [lecturio.com]
Common symptoms and signs include cough, fever, chills, fatigue, dyspnea, rigors, sputum production, and pleuritic chest pain. [msdmanuals.com]
[…] ice-making machines, and misting systems typically found in grocery-store produce sections. [15] [25] The bacteria may also be transmitted from contaminated aerosols generated in hot tubs if the disinfection and maintenance programs are not followed rigorously [en.wikipedia.org]
Gastrointestinal
- Food Poisoning
Shigella dysenteriae causes bacillary dysentery: Salmonella enterica, causes food poisoning and gastroenteritis. Salmonella typhi, which infects via the intestinal route, causes typhoid fever. [textbookofbacteriology.net]
Food Poisoning You must report the following cases immediately by calling 866-692-3641: Food poisoning in a group of two or more people. This includes clusters of diarrhea or other gastrointestinal symptoms. [nyc.gov]
Cryptosporidiosis [PDF] Cyclosporiasis [PDF] D Diphtheria [PDF] E Echinococcus mutilocularis infection [PDF] Encephalitis, including: i) Primary, viral; ii) Post-infectious; iii) Vaccine-related; iv) Subacute sclerosing panencephalitis; and v) Unspecified [PDF] F Food [health.gov.on.ca]
Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. Antiemetics, vomiting Vomiting The forcible expulsion of the contents of the stomach through the mouth. [lecturio.com]
Food poisoning C. perfringens or welchii Standard n/a Not transmitted from person to person. Food poisoning Staphylococcal Standard n/a Not transmitted from person to person. [cdc.gov]
Neurologic
- Headache
Manifestations Mild flu-like illness ( headache Headache The symptom of pain in the cranial region. It may be an isolated benign occurrence or manifestation of a wide variety of headache disorders. [lecturio.com]
The non-pneumonic illness – also known as Pontiac Fever – includes flu-like symptoms such as fever, headache, malaise, chills, and muscle pain. [iamat.org]
Symptoms may include fever, headache, malaise, and muscle aches. [dshs.texas.gov]
Patients with the usual form of meningitis (bacterial or viral) get very ill quickly and usually develop fever, headache, and neck stiffness. [moldbacteria.com]
Patients present with headache and papilledema, while CSF is unremarkable. [karger.com]
- Confusion
Topic Images Snapshot A 60-year-old man is brought to the emergency department for confusion, cough, and diarrhea. He had recently attended a conference and stayed at an old hotel where other people reported similar symptoms. [step1.medbullets.com]
It can start with symptoms similar to influenza (flu), and will often also cause nausea, vomiting, increased sensitivity to light, rash, and confusion. If you think you or your child has any of these symptoms, call the doctor right away. [healthy.arkansas.gov]
Legionellaand HIV Coinfection with HIV confused timely diagnosis in this patient with Legionellosis. [bmcinfectdis.biomedcentral.com]
Abdominal pain, nausea, vomiting, and diarrhea are also common, and some people may have confusion or other mental changes. Pontiac Fever presents as a self-limited febrile illness that does not result in pneumonia. [dshs.texas.gov]
The next day he arrived at a New Orleans hospital disoriented, confused and combative. [consumer.healthday.com]
- Altered Mental Status
Due to the combination of altered mental status, headache, and fever, a lumbar puncture was performed. [bmcinfectdis.biomedcentral.com]
Minor Criterion (2 required for possible encephalitis, ≥3 required for probable or confirmed encephalitis) Patient presenting for medical attention with altered mental status (defined as decreased or altered level of consciousness, lethargy, or personality [arupconsult.com]
As the brain is often affected, confusion or an altered mental status are almost ubiquitous.2–5 In addition, brainstem and cerebellar symptoms such as ataxi2,5 or dysarthria,2,5 from which our patient also suffered, are also frequently observed. [journalpulmonology.org]
mental status dyspnea relative bradycardia pneumonia Imaging Chest radiography indication all patients findings lobar consolidation or diffuse patchy infiltrates Studies Labs urine antigen test diagnostic does not Gram stain well, so it requires a silver [step1.medbullets.com]
mental status, neck stiffness there may be variations in clinical presentation due to the type of pathogen, patient age, host immune status Bacterial causes of meningitis by age < 1 month Group B streptococcus (GBS), E. coli, L. monocytogenes prominent [medbullets.com]
- Guillain-Barré Syndrome
Patients with Legionnaire's may be at increased risk of, and rarely develop, immune-mediated multifocal brain (acute disseminated encephalomyelitis) or peripheral nerve disease (Guillain-Barré syndrome). [pubmed.ncbi.nlm.nih.gov]
Neurologic derangements include aseptic meningitis, cerebral ataxia, encephalitis, Guillain-Barré syndrome, and transverse myelitis. The production of cold agglutinins can result in hemolytic anemia, especially when M. pneumoniae titers are high. [aafp.org]
Acinetobacter baumannii Xanthomonadaceae Stenotrophomonas maltophilia Cardiobacteriaceae Cardiobacterium hominis HACEK Aeromonadales Aeromonas hydrophila / Aeromonas veronii Aeromonas infection ε Campylobacterales Campylobacter jejuni Campylobacteriosis, Guillain–Barré [en.wikipedia.org]
Giardiasis (see Gastroenteritis) n/a n/a n/a Gonococcal ophthalmia neonatorum (gonorrheal ophthalmia, acute conjunctivitis of newborn) Standard n/a n/a Gonorrhea Standard n/a n/a Granuloma inguinale (Donovanosis, granuloma venereum) Standard n/a n/a Guillain-Barré [cdc.gov]
- Stroke
Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation: analysis of pooled data from five randomized controlled trials. الصفحة 1246 - Barnett HJ, Taylor DW, Eliasziw M et al. [books.google.com]
It can impede blood vessels in the brain and lead to stroke and brain impairment. It also harms other body parts. [omicsonline.org]
CT scan: Can help to rule out space-occupying lesions, strokes and basilar fractures of the skull and to detect CSF leaks to localise fracture sites. [patient.info]
Computed tomography (CT), with and without contrast enhancement, should be used only if MRI is not available (Zunt, IDSA, 2008) Other Tests EEG – may demonstrate seizure activity; most useful in HSV Differential Diagnosis (Noninfectious) Vascular disease Stroke [arupconsult.com]
Workup
[…] separate venipuncture sites prior to the administration of antibiotics Other site cultures may be helpful based on other symptoms suggesting infection – sputum, urine, pleural/peritoneal/synovial fluid, stool, skin lesions Routine studies for encephalitis workup [arupconsult.com]
Yield of workup for patients with idiopathic presentation of the syndrome of inappropriate antidiuretic hormone secretion. Eur. J. Intern. Med. 2016, 32, 60–64. [mdpi.com]
X-Ray
- Pulmonary Infiltrate
Chest pain is common in immunocompromised patients, and can be confused with pulmonary thromboembolism. These patients can also present fever alone, with no other symptoms of pneumonia, despite radiological evidence of pulmonary infiltrates. [elsevier.es]
All patients with a diagnosis of Legionnaires' disease or bacteremic pneumococcal pneumonia had clinical findings consistent with acute pneumonia including pulmonary infiltrates on chest roentgenography. [journals.plos.org]
Treatment
Dose Adjustments Resistant organism development AND no response to treatment: Treatment should be modified. [drugs.com]
An early diagnosis using molecular techniques is an essential tool for the effectiveness of the treatment. [progenie-molecular.com]
"Cannabidiol showed a low tendency to cause resistance in bacteria even when we sped up potential development by increasing concentrations of the antibiotic during 'treatment'." [news-medical.net]
Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. [betterhealth.vic.gov.au]
Antibiotic treatment is empiric and includes coverage for both typical and atypical organisms. [aafp.org]
Prognosis
Aciclovir has been shown to greatly improve the prognosis if given before coma develops but any delay in starting treatment leads to a much worse prognosis. [patient.info]
FLAIR : hyperintense DWI : hyperintense ADC: hypointense T1 C+ (Gd) : linear cranial nerve enhancement ring enhancement (abscess) heterogeneous if extensive inflammation MR spectroscopy : allows differentiation between abscess from tumor Treatment and prognosis [radiopaedia.org]
Legionnaires disease (most common) lobar or insterstitial pneumonia gastrointestinal and central nervous system involvement more common in smokers and those with chronic lung diseases Pontiac fever mild and flu-like without significant pulmonary involvement Prognosis [step1.medbullets.com]
Legionella as it is an intracellular bacterium Treatment with antibiotics like macrolides or quinolones that penetrate the infected cells is required Diagnostic methods to confirm the presence of Legionella in the initial phase are important for the prognosis [oxfordbiosystems.com]
Treatment and prognosis Macrolides or quinolones are the treatment of choice. [elsevier.es]
Etiology
Naegleria fowleri is the etiological agent of primary amoebic meningoencephalitis (PAM), a rapidly fatal disease. [asu.pure.elsevier.com]
Relative lymphocytosis suggests a viral etiology Electrolyte panel, liver function studies – useful to rule out metabolic encephalopathy Elevated transaminases – consider tickborne disease testing if appropriate clinical history C-reactive protein (CRP [arupconsult.com]
Depending on their ages, individuals are also predisposed to certain etiologic agents. Incubation Period The incubation period depends on the causative agent. [ehagroup.com]
According to this study, the etiology of SIADH is an important prognostic factor of survival [78]. The mentioned SIADHs etiology is of great importance since it determines the patient’s prognosis. [mdpi.com]
Epidemiology
Harrison Abstract The aims of this work were to assess (i) the intercentre reproducibility and epidemiological concordance of amplified fragment length polymorphism analysis for epidemiological typing of Legionella pneumophila serogroup 1, and (ii) the [link.springer.com]
His work to date has covered the areas of paediatrics HIV/AIDS, tuberculosis epidemiology and the epidemiology of vaccine-preventable diseases. [meningitis.org]
Cited by Legionella pneumophila Infections during a 7-Year Retrospective Analysis (2016-2022): Epidemiological, Clinical Features and Outcomes in Patients with Legionnaires' Disease. [pubmed.ncbi.nlm.nih.gov]
Currently, no prospective studies have been conducted in Sabah, East Malaysia to define the epidemiology and aetiology of CNS infections. [bmcinfectdis.biomedcentral.com]
There is scant reference in the literature to epidemiological studies on the prevalence of atypical pneumonias in Mexico, and what little information is available is out-dated. [elsevier.es]
Pathophysiology
McMaster Pathophysiology Review. Retrieved 29 March 2020. ^ Walter, Edward James; Hanna-Jumma, Sameer; Carraretto, Mike; Forni, Lui (14 July 2016). "The pathophysiological basis and consequences of fever". [en.wikipedia.org]
The pathophysiology of amoebic meningoencephalitis is still an enigma, and of late, the mechanisms appear to be shifting from agent-based pathogenic potential to host-based immunogenic response. [4] A short summary of the features based on the published [neurologyindia.com]
Leakage from damaged pial vessels, leading to focal extravasation of the contrast agent into the CSF adjacent to the brain, is the most likely pathophysiological explanation for leptomeningeal enhancement on FLAIR images [ 15 ], indicating blood-CSF barrier [karger.com]
Legionellosis refers to 2 distinct clinical syndromes: Legionnaires disease, which most often manifests as severe pneumonia accompanied by multisystemic disease, and Pontiac fever, which is an acute, febrile, self-limited, viral-like illness. [1, 2] Pathophysiology [emedicine.medscape.com]
Hyponatremia in cirrhosis: Pathophysiology and management. World J. Gastroenterol. 2015, 21, 3197–3205. [mdpi.com]
Prevention
The Centers for Disease Control and Prevention (CDC) is a United States federal agency under the Department of Health and Human Services headquartered in Atlanta, Georgia. Gary W. [books.google.com]
INFECTION PREVENTION ASAP* ] Croup (see Respiratory infections in infants and young children) Cryptococcosis Cryptosporidiosis (see Gastroenteritis) Cytomegalovirus infection, neonatal or immunosuppressed D Diarrhea, acute-infective etiology suspected [ww2.mc.vanderbilt.edu]
Prevention Check if your planned accommodation has had an outbreak of Legionellosis in the past. Ask what prevention measures the company is taking to prevent infection. [iamat.org]