Diagnostics of the legionellosis
Last reviewed: 23.04.2024
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Diagnosis of legionellosis is based on the isolation of the culture of L. Pneumophilla from blood, sputum, washing water of the bronchi, pleural fluid. Serological diagnosis of legionellosis is carried out using the methods of RIF and ELISA. Diagnostic value is the study of paired sera in the dynamics of the disease. Diagnostic titer for a single serum 1: 128 study. Apply genodiagnostics using the PCR method.
[Indications for consultation of other specialists
Indications for the consultation of a neurologist are the development of meningoencephalitis in the acute period of the disease and signs of asthenovegetative syndrome in the period of convalescence, to consultation of an ENT doctor - nosebleeds, to a gynecologist's consultation - uterine bleeding.
Indications for hospitalization
The presence of intoxication in combination with the symptoms of the defeat of the respiratory tract and the central nervous system.
Differential diagnostics of legionellosis
The diagnosis of legionellosis according to clinical data at present can be established only taking into account epidemiological data. Pneumonia of legionellosis etiology should be differentiated from pneumonia of another etiology, primarily from atypical pneumonia (ornithosis, ku-fever, respiratory mycoplasmosis), as well as pneumococcal, hemophilic, staphylococcal, Klebsiellose pneumonia. In connection with the clinical similarity of pneumonia of different etiology, the results of microbiological and immunological studies are crucial.
The clinical course of the legionnaires' disease has its own characteristics, which can be important in differential diagnosis. Dry continuous cough, characteristic of mycoplasmal pneumonia, differs from a moderate, rare cough at the beginning of the disease of legionnaires. The absence of a significant cough with extensive lesions of lung tissue distinguishes legionellosis from pneumonia pneumococcal and klebsiellolevoznoy etiology. The defeat of the CNS with legionellosis is much more common than with pneumonia of another etiology.
The assumption of legionellosis can arise if treatment of pneumonia with cephalosporins is ineffective.