[Legionella infections. Diagnostic and therapeutic problems at intensive care units]

Legionnaires' Disease may pose great diagnostic problems in an intensive care setting. The serological diagnosis is often considerably delayed, and, on account of the invasive therapeutic and monitoring procedures employed, the risk of diagnostic errors caused by bacterial contamination (or of genuine superinfection) is high. Therefore, specific antibiotic treatment, instituted on the clinical suspicion of severe legionellosis, should only be discontinued on definite indications (such as severe allergic or toxic reactions to the treatment). Three cases of severe legionellosis are presented to illustrate this.