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Nervous System Abnormalities and Legionnaire's Disease.

John J Halperin1

  • 1Sidney Kimmel Medical College of Thomas Jefferson University, 99 Beauvoir Avenue, Summit, NJ 07902, USA; Department of Neurosciences, Overlook Medical Center, 99 Beauvoir Avenue, Summit, NJ 07902, USA.

Infectious Disease Clinics of North America
|December 17, 2016
PubMed
Summary

Legionnaire's disease can cause altered consciousness, similar to other severe bacterial pneumonias. While rare, neurological complications like polyneuropathy or Guillain-Barré syndrome can occur in Legionnaire's patients.

Keywords:
Critical illness polyneuropathyEncephalopathyLegionnaire’s diseaseNervous system abnormalitiesParainfectious

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Legionnaire's disease, a severe bacterial pneumonia, can present with neurological symptoms.
  • Understanding the spectrum and frequency of these neurological manifestations is crucial for patient management.

Purpose of the Study:

  • To clarify the incidence and nature of neurological complications in Legionnaire's disease.
  • To compare these complications with those seen in other severe bacterial pneumonias.

Main Methods:

  • Review of clinical data from patients with Legionnaire's disease.
  • Comparison with control groups of patients with other severe bacterial pneumonias.
  • Analysis of neurological examination findings, neuroimaging (MRI), and electrodiagnostic studies.

Main Results:

  • Alterations of consciousness are common but not more frequent than in other severe bacterial pneumonias.
  • Legionella meningitis is exceedingly rare.
  • Patients are susceptible to critical illness polyneuropathy/myopathy and may show MRI hyperdensities.
  • A potential increased risk for immune-mediated neurological conditions, including acute disseminated encephalomyelitis and Guillain-Barré syndrome, exists.

Conclusions:

  • Neurological complications of Legionnaire's disease are generally similar in frequency to other severe bacterial pneumonias.
  • While rare, specific immune-mediated neurological conditions warrant consideration in susceptible patients.
  • Distinguishing Legionnaire's disease-related neurological issues from other critical illness complications is important.