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The typical presentation of an atypical pathogen during an outbreak of Legionnaires’ disease in Vila Franca de Xira, Portugal, 2014
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Orientador(es)
Resumo(s)
Background: An outbreak of Legionella pneumophila serogroup 1, with 403 cases was identified
on the 7th November 2014 in Vila Franca de Xira, Portugal. Outbreak source was the wet cooling
system of a local factory. Hospital Pulido Valente was one of the hospitals receiving patients
with Legionnaires’ disease (LD).
Methods: We describe the clinical findings and diagnostic methods used among the 43 confirmed
or probable cases admitted to our department.
Results: 60.5% were male, mean age was 56.1 ± 13.5 years and tobacco smoking was the most
frequent risk factor (76.7%). All patients had fever, 62.8% ≥39.5 ◦C, 72.1% had chills and myalgia/arthralgia
and 62.8% had dry cough. Extra pulmonary symptoms were frequent: confusion
and headache occurred in 34.9% and gastrointestinal symptoms in 20.9%.
High C-Reactive Protein (55.8% ≥30 mg/dL) and hyponatremia (62.8%) were the laboratorial
abnormalities most commonly found. Hypoxemia occurred in 55.8% and hypocapnia in 93%.
Urinary Antigen Test (UAT) was positive in 83.7% of the cases.
Conclusions: Although not specific, a combination of risk factors, symptoms and laboratory
findings can be highly suggestive of LD, even in an outbreak. This should prompt diagnosis
Descrição
Palavras-chave
Legionella pneumophila serogroup 1 Legionnaires’ Disease Outbreak Clinical Presentation Vila Franca de Xira Portugal Estado de Saúde
Contexto Educativo
Citação
Rev Port Pneumol (2006). 2017 May - Jun;23(3):117-123. doi: 10.1016/j.rppnen.2017.01.007. Epub 2017 Mar 1.
Editora
Elsevier/Sociedade Portuguesa de Pneumologia