Legionella pneumonia/Legionnaires' disease

Question 1

Legionella pneumonia, also known as Legionnaires’ disease, is a severe form of atypical pneumonia caused by the Gram-negative, facultative intracellular bacteria Legionella pneumophila. What is the incidence of this?

1 - 0.40 cases per 100,000
2 - 40 cases per 100,000
3 - 400 cases per 100,000
4 - 4000 cases per 100,000

Answer 1

1 - 0.40 cases per 100,000

Equally as common in men and women

Question 2

Legionella pneumonia, also known as Legionnaires’ disease, is a severe form of atypical pneumonia caused by the Gram-negative, facultative intracellular bacteria Legionella pneumophila. What age does the incidence of this peak at?

1 - 1-16
2 - 20-40
3 - 50-70
4 - >70

Answer 2

4 - >70

Question 3

Legionella pneumonia, also known as Legionnaires’ disease, is a severe form of atypical pneumonia caused by the Gram-negative, facultative intracellular bacteria Legionella pneumophila. Is this a notifiable disease?

Answer 3

• Yes

Must contact the The UK Health Security Agency

Question 4

Legionella pneumonia is typically transmitted how?

1 - air droplets form colonised air con
2 - colonised water
3 - sexual contact
3 - faecal oral route

Answer 4

1 - air droplets form colonised air con
2 - colonised water

Basically anywhere water is

Most common is serotype 1 is the most common cause of Legionnaires disease

Question 5

Legionella pneumonia is common in all of the following, EXCEPT which one?

1 - UK
2 - Italy
3 - France
4 - Spain
5 - Germany

Answer 5

1 - UK

This is because these places are warmer and require more water cooling equipment

Question 6

What is the incubation period for Legionella pneumonia?

1 - <10 days
2 - 2-14 days
3 - <21 days
4 - 30-120 days

Answer 6

2 - 2-14 days

Question 7

Which of the following is NOT a risk factor for developing Legionella pneumonia?

1 - Elderly patients
2 - Current or former smokers
3 - Chronic lung disease
4 - Immunocompromised
5 - Female gender

Answer 7

5 - Female gender

Question 8

All of the following are common, but what is typically the first sign of Legionella pneumonia?

1 - flu-like symptoms with fever
2 - dry cough
3 - relative bradycardia
4 - confusion
5 - lymphopaenia
6 - hyponatraemia
7 - deranged liver function tests
8 - pleural effusion: seen in around 30% of patients

Answer 8

1 - flu-like symptoms with fever

Occurs in 90% of patients

Question 9

What is the most common method for diagnosing patients with Legionella pneumonia?

1 - serum ELISA
2 - urine antigen PCR
3 - plasma PCR
4 - swab

Answer 9

2 - urine antigen PCR

PCR can be tested on any sample

Question 10

What is the most common finding on a chest X-ray in a patient with Legionella pneumonia?

1 - ground-glass opacities
2 - cavitation
3 - patchy unilobar infiltrates, which can progress to consolidations

Answer 10

3 - patchy unilobar infiltrates, which can progress to consolidations

Question 11

What is the first line treatment for Legionella pneumonia?

1 - Benzylpenicillin
2 - Clindamycin
3 - Levofloxacin
4 - Vancomycin

Answer 11

3 - Levofloxacin

Clarithromycin or Azithromycin can be alternatives

Given for 7-10 days