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.
 
==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===
 
====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.
 
====Polymerase Chain Reaction====
 
[[Polymerase chain reaction|Polymerase chain reaction (PCR)]] is used to detect [[DNA]] of [[Legionella]] in sputum, pleural fluid, [[bronchoalveolar lavage]] samples, pulmonary tissues, urine, or environmental water.  The detection rate by qualitative PCR is usually high, at > 90% of positive samples.
 
====Serology====
 
A four-fold or greater increase in antibody titer between the acute and convalescent sera is diagnostic.
 
====Immunofluorescent microscopy====
 
Detection of Legionella in respiratory tract tissues or fluids by immunofluorescent microscopy may be used.


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


[[Category:Infectious disease]]
 
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Medical disasters]]
[[Category:Medical disasters]]

Latest revision as of 18:09, 18 September 2017