Legionnaires' disease

An isolated case of Legionnaires' disease

A single sporadic case of Legionnaires' disease which showed some unusual features is described from a young male who had never been out of the United Kingdom. The relevant literature is briefly reviewed.

A fatal case of Legionnaires' disease originating in Scotland

A 21-year-old female died in May 1976 from a pneumonic illness presenting with a right pleural effusion. Histopathology showed florid hyaline membrane disease of the left lung only, and focal pneumonitis in the lower lobe. Further investigations carried out by the Center for Disease Control, Atlanta, Georgia, showed that this patient had Legionnaires' disease infection, the first indigenous case diagnosed in Scotland. Post-mortem examination showed features differing from those in other published cases.

Pathology of five Scottish deaths from pneumonic illnesses acquired in Spain due to Legionnaires' disease agent

The pathology and histology are reported of five Scots who died of severe pneumonic illnesses after holidays in Spain, three in 1973 and two in 1977. There is strong evidence in favour of all the deaths having been due to the newly discovered Legionnaires' disease (LD) agent. The agent (or its soluble antigen) has been visualised in sections of lung tissue by fluorescent-antibody tests in all cases, and the agent has been identified by the Dieterle silver staining method in small numbers in all cases. Serological testing was possible in three of the patients, and two had very high antibody titres against the LD agent. Apart from the extensive and severe nature of the pathological process there is no feature to distinguish pulmonary infection by this agent from that due to more commonly known bacteria capable of causing lobar pneumonia. The severity and extensive nature of the process is partly a reflection of neglect in seeking treatment until late in the infection, and partly a reflection, as revealed in retrospect, on the use of the wrong antibiotic combination during treatment. Erythromycin has been recommended by other workers as the drug of choice against the LD agent. Infection by this organism is not confined to the USA or to Spain and is indigenous also in the United Kingdom.

Legionnaires' Disease--the Benidorm episode

The clinical pattern of illness in 2 fatal cases of Legionnaires' Disease is described. Common factors in the 2 patients were residence in a hotel in Benidorm, Spain, a severe and progressive pneumonia unaffected by wide-spectrum antibiotics and failure to incriminate an infecting organism. The similarities with the Philadelphia outbreak, in which a bacillus known as the Legionnaire agent was isolated, led to a retrospective diagnosis in the Benidorm episode. Subsequent serological surveys indicate that Legionnaires' Disease is widespread in nature; it is not a new disease.