Legionnaires' disease

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Symptoms

By Mayo Clinic staff

Legionnaires' disease usually develops two to 14 days after exposure to legionella bacteria. It frequently begins with the following signs and symptoms:

  • Headache
  • Muscle pain
  • Chills
  • Fever that may be 104 F (40 C) or higher

By the second or third day, you'll develop other signs and symptoms that may include:

  • Cough, which may bring up mucus and sometimes blood
  • Shortness of breath
  • Chest pain
  • Fatigue
  • Loss of appetite
  • Gastrointestinal symptoms, such as nausea, vomiting and diarrhea
  • Confusion or other mental changes

Although Legionnaires' disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.

A mild form of Legionnaires' disease — known as Pontiac fever — may produce symptoms including fever, chills, headache and muscle aches. Pontiac fever doesn't infect your lungs, and symptoms usually clear within two to five days.

When to see a doctor
See your doctor if you think you've been exposed to legionella bacteria. Be sure to mention any trips you've taken in the past two weeks and where you stayed. Diagnosing and treating Legionnaires' disease as soon as possible can help shorten the recovery period and prevent serious complications. For people at high risk, prompt treatment is critical.

References
  1. Pedro-Botet ML, et al. Epidemiology and pathogenesis of Legionella infection. http://www.uptodate.com/home/index.html. Accessed Oct. 13, 2010.
  2. Patient facts: Learn more about Legionnaires' disease. Centers for Disease Control and Prevention. http://www.cdc.gov/legionella/patient_facts.htm. Accessed Oct. 13, 2010.
  3. Edelstein PH, et al. Legionella. In: Mandell GL, et al. Mandell, Douglas, and Bennett's Principles and Practices of Infectious Diseases. 7th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2010. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-0-443-06839-3&eid=4-u1.0-B978-0-443-06839-3..00232-0. Oct. 14, 2010.
  4. Pedro-Botet ML, et al. Treatment and prevention of legionella infection. http://www.uptodate.com/home/index.html. Accessed Oct. 13, 2010.
  5. Top 10 things every clinician needs to know about legionellosis. Centers for Disease Control and Prevention. http://www.cdc.gov/legionella/top10.htm. Accessed Oct. 13, 2010.
  6. Pedro-Botet ML, et al. Clinical manifestations and diagnosis of legionella infection. http://www.uptodate.com/home/index.html. Accessed Oct. 13, 2010.
  7. Neil K, et al. Increasing incidence of legionellosis in the United States, 1990-2005: Changing epidemiologic trends. Clinical Infectious Diseases. 2008;47:591.
  8. Nhu Nguyen TM, et al. A community-wide outbreak of Legionnaires disease linked to industrial cooling towers — How far can contaminated aerosols spread? Journal of Infectious Diseases. 2006;193:102.
  9. Centers for Disease Control and Prevention, et al. Legionnaires' disease associated with potting soil — California, Oregon, and Washington, May-June 2000. MMWR. 2000;49:777. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4934a1.htm. Accessed Oct. 19, 2010.
  10. Legionellosis. World Health Organization. http://www.who.int/mediacentre/factsheets/fs285/en/index.html. Accessed Oct. 19, 2010.
  11. Sabria M, et al. Legionella infection. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aid=2871241. Accessed Oct. 13, 2010.
  12. Cunha BA. Legionnaires' disease: Clinical differentiation from typical and other atypical pneumonias. Infectious Disease Clinics of North America. 2010;24:73.
DS00853 Dec. 10, 2010

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