Legionellosis other diagnostic studies: Difference between revisions

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{{Legionellosis}}
{{Legionellosis}}
{{CMG}}
==Overview==
==Overview==
 
Additional studies are not required for the diagnosis of legionellosis.
Sputum culture and urine antigen testing are the two preferred diagnostic studies.  Serologic assays should be used if both culture and urine antigen test are negative in the presence of clinical or epidemiologic clues.  For patients who are more likely to have infection not caused by Lp serogroup 1, the best laboratory tests may be sputum culture and PCR.
 
==Other Diagnostic Studies==
==Other Diagnostic Studies==
 
Additional studies are not required for the diagnosis of legionellosis.
===Sampling===
 
====Bronchoalveolar Lavage====
 
[[Bronchoalveolar lavage|Bronchoalveolar lavage (BAL)]] fluids can be submitted for cultures and [[PCR]] in pediatric patients.
 
====Thoracocentesis====
 
[[Thoracocentesis]] may be performed to obtain [[pleural fluid]] samples in the presence of significant effusion.
 
===Assay===
 
====Polymerase Chain Reaction====
 
[[Polymerase chain reaction|Polymerase chain reaction (PCR)]] is used to detect [[DNA]] of [[Legionella]] in urine, blood, pleural fluid, or [[bronchoalveolar lavage]] samples.  PCR is an alternative tool for rapid Legionella detection in environmental water.  The detection rate of Legionella DNA by qualitative PCR is usually high, at > 90% of positive samples.
 
====Culture====
 
Expectorated sputum, endotracheal aspirates, pleural fluid, blood, or tissue samples may be sent for culture.  Unlike serology and urine antigen testing, the yield of cultures is independent of serotype and may be positive in cases of non-''Legionella pneumophila'' species.
 
====Urinary antigen testing====
 
Urine antigen testing is most sensitive for the detection of the Pontiac subtype of Legionella pneumophila serogroup 1.  Tests to detect L. pneumophila SG 1 antigen in urine allows  for early diagnosis.
 
====Immunofluorescent microscopy====
 
Detection of Lp in respiratory tract tissues and fluids using immunofluorescent microscopy (DFA) may be useful in fixed lung specimens.
 
===Serology===
 
Measurement of antibodies to serogroup 1 often has a low sensitivity and specificity unless paired acute and convalescent sera are tested.


==References==
==References==
{{reflist|2}}
{{reflist|2}}


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Latest revision as of 18:09, 18 September 2017