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075 - Laboratory diagnosis of Legionnaires’ disease

Autor(s): I. Bianco, A. Conti

Issue: RIMeL - IJLaM, Vol. 5, N. 3-S1, 2009 (MAF Servizi srl ed.)

Page(s): 75-80

Summary
Nowadays Legionella pneumophila can be ascribed among the most serious pathogens involved in deep airway infections, namely both community and hospital acquired pneumonias that, often misdiagnosed, can evolve into a serious and even deathly threat for the patient. Legionnaires’ disease can be diagnosed by specific laboratory tests. Since none of them – as a single test – is able to detect the disease, especially in its early stage, several tests should be applied in combination for maximum sensitivity. The most sensitive and effective test for Legionella pneumophilia detection is the culture of respiratory tract secretions. A urine antigen test using EIA is a practical, reliable and convenient approach. It is also useful to adopt fluorescent assays to look for the germ directly on clinical specimens. Serological testing is more useful to epidemiologists than it is to clinicians, because of cross-reactions with antibodies to unrelated organisms. Molecular amplification tests, such as polymerase chain reaction (PCR), are used in some research and public health laboratories and produce fast and reliable results, although there are also reports of unreliable or insensitive PCR tests. This case is a reminder of the importance of the Consultant Medical Microbiologist, whose skills and competences lead the entire diagnostic process. Key-words: Legionellosis, community and hospital-acquired pneumonia, microbiological investigation, laboratory’s method evaluation.

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