legionnaire's disease…

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legionnaires' disease organism, legionella, legionella pneumonia, pontiac fever, legionnaire's disease, acute respiratory infection, bacterium legionella pneumophila, cause a broad spectrum of disease from mild cough, fever to a serious pneumonia, bacteria that cause legionnaire's disease have been found in water delivery systems, survive, in the warm, moist, air conditioning systems of large buildings, hospitals, infection is transmitted, the respiratory system, person-to-person spread has not been proved, onset of symptoms, condition typically worsens, first 4 to 6 days, improvement starting in another 4 to 5 days, most infection occurs in middle-aged, older people, it has been reported in children, disease is less severe in children, risk factors include cigarette smoking, underlying diseases renal failure, cancer, diabetes, chronic obstructive pulmonary disease, suppressed immune systems from chemotherapy, steroid medications, diseases cancer, leukemia, alcoholism, middle-aged, elderly, in people on a ventilator, extended periods, muscle aches, stiffness, joint pain, loss of energy, general discomfort, uneasiness, ill feeling, malaise, headache, fever, shaking chills, nonproductive cough, coughing of blood, shortness of breath, chest pain, diarrhea, ataxia, lack of coordination, listening, chest, a stethoscope reveals fine crackles, sputum direct fluorescent antibody staining shows legionella, causative organism cultured, airway, urine tests, the bacteria, urine antigen test, positive, chest x-ray shows pneumonia, arterial blood gas analysis, low concentrations of oxygen, cbc shows an increased white blood cell count, erythrocyte sedimentation rate is increased, low serum sodium, liver function tests, moderate elevation, goal of treatment, eliminate the infection, antibiotics, treatment is started, legionnaire's disease is suspected, waiting, confirmation by culture results, antibiotics commonly used, quinolones, ciprofloxacin, levofloxacin, moxifloxacin, gatifloxacin, or macrolides, azithromycin, clarithromycin, erythromycin, supportive treatment includes hospitalization, fluid, electrolyte replacement, oxygen administration by mask, by mechanical ventilation, respiratory system becomes severely compromised by the infection, overall death rate, pneumonia, 15%, death rate increases in those, underlying diseases, mortality, patients who develop legionnaire's disease hospitalized is close to 50%, antibiotics, started late, complications include respiratory failure requiring use of a respirator, breathing difficulties develop, active surveillance of infections that were acquired, a hospital, lead, treatment of contaminated water delivery systems, detection, treatment of sources outside hospitals, occurs, after an epidemic has happened.