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Pulmonary and extrapulmonary manifestations of L. pneumophila
Abstract:
In three of five fatal cases of Legionnaires' Disease (LD) bacteria have been detected by DFA in extrapulmonary organs including spleen, liver, kidney, heart and brain. Typical fluorescent pleomorphic rods were seen mostly intravascularly and occasionally in phagocytes of the mononuclear phagocytic system. Legionellae were found extravascularly in the myocard and in the brain tissue together with single cell necrosis of either muscle fibres or ganglion cells in the respective organ. It was of special interest in this context that the clinical data and functional abnormalities reported for the respective cases might well be explained by the histopathological findings.
Insights
Legionnaires
Area of Science:
- Medical Microbiology
- Pathology
Background:
- Legionnaires' Disease (LD) is a severe pneumonia.
- Extrapulmonary involvement in fatal LD cases is not fully understood.
Purpose of the Study:
- To investigate the presence and location of Legionella bacteria in extrapulmonary organs in fatal Legionnaires' Disease cases.
- To correlate histopathological findings with clinical manifestations.
Main Methods:
- Direct fluorescent antibody (DFA) staining was used to detect Legionella bacteria.
- Histopathological examination of extrapulmonary organs (spleen, liver, kidney, heart, brain) from fatal LD cases.
Main Results:
- Legionella bacteria were detected in extrapulmonary organs in 3 of 5 fatal cases.
- Bacteria were observed intravascularly and within phagocytes, as well as extravascularly in the myocardium and brain.
- Extravascular presence correlated with single-cell necrosis in affected tissues.
Conclusions:
- Legionella bacteria can disseminate to and cause damage in extrapulmonary organs during fatal Legionnaires' Disease.
- Histopathological findings in extrapulmonary sites may explain observed clinical abnormalities.