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Disease Profile

Legionnaires’ disease

Prevalence
Prevalence estimates on Rare Medical Network websites are calculated based on data available from numerous sources, including US and European government statistics, the NIH, Orphanet, and published epidemiologic studies. Rare disease population data is recognized to be highly variable, and based on a wide variety of source data and methodologies, so the prevalence data on this site should be assumed to be estimated and cannot be considered to be absolutely correct.

Unknown

Age of onset

All ages

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ICD-10

A48.1

Inheritance

Autosomal dominant A pathogenic variant in only one gene copy in each cell is sufficient to cause an autosomal dominant disease

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Autosomal recessive Pathogenic variants in both copies of each gene of the chromosome are needed to cause an autosomal recessive disease and observe the mutant phenotype

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X-linked
dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.

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X-linked
recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder

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Mitochondrial or multigenic Mitochondrial genetic disorders can be caused by changes (mutations) in either the mitochondrial DNA or nuclear DNA that lead to dysfunction of the mitochondria and inadequate production of energy.

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Multigenic or multifactor Inheritance involving many factors, of which at least one is genetic but none is of overwhelming importance, as in the causation of a disease by multiple genetic and environmental factors.

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Not applicable

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Other names (AKA)

Legionellosis; Legionnaires disease

Categories

Bacterial infections

Summary

Legionnaires’ disease is a severe type of pneumonia caused by the bacteria Legionella.[1] The species Legionella pneumophila causes most cases, but other species of Legionella can also cause the disease. It is named Legionnaires’ disease because it was first discovered after a pneumonia outbreak among people who attended an American Legion Convention in Philadelphia, Pennsylvania in 1976.[2]

Most people exposed to Legionella do not become sick with Legionnaires' disease.[3] People who do become sick usually develop symptoms within 2 to 10 days after exposure, but it may take longer. The first symptoms may include headache, chills, muscle pains, and a fever that can be 104°F (40°C) or higher.[1] Additional symptoms usually develop 1 to 2 days after the first symptoms and may include coughing, shortness of breath, chest pain, diarrhea, nausea and vomiting, and confusion.[1][4] While Legionnaires’ disease mainly affects the lungs, it sometimes causes infections in other parts of the body, such as the heart or within body wounds.[1]

A person can become infected from Legionella when they inhale mist or water droplets that contain the bacteria.[1][3] Sources of exposure may include showers, faucets, whirlpools, grocery store misters, and water droplets passing through ventilation systems in large buildings (such as hotels, office buildings, and hospitals).[1] People who are more susceptible to developing Legionnaires' disease after an exposure include adults over age 50, current or former smokers, and people who have a weakened immune system or a chronic disease.[1][3] Generally, neither the bacteria nor Legionnaires' disease is spread directly from person to person.[5][6] While large exposures can result in outbreaks, the disease usually occurs in single, isolated cases.[7]

Legionnaires' disease may be suspected by symptoms. Pneumonia can be confirmed by a chest X-ray. Legionnaires' disease is diagnosed when one of the species of Legionella is found to be the cause of the pneumonia by testing a urine sample (urine culture) or a sample of saliva and mucus that is coughed up (sputum culture).[8] Without treatment, the disease can be fatal.[1] People with the disease who are otherwise healthy usually recover with antibiotics, although they may need to be cared for in a hospital. About 1 in 10 people with Legionnaires’ disease will not survive due to complications such as respiratory failure, kidney failure, or septic shock.[1][8]

Of note, Legionella can also cause a milder illness called Pontiac fever, which causes flu-like symptoms, but does not cause pneumonia. Pontiac fever typically goes away without specific treatment.[8]

Symptoms

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

Medical Terms Other Names
Learn More:
HPO ID
80%-99% of people have these symptoms
Cough
Coughing
0012735
Fatigue
Tired
Tiredness

[ more ]

0012378
Fever
0001945
Myalgia
Muscle ache
Muscle pain

[ more ]

0003326
Pulmonary infiltrates
Lung infiltrates
0002113
30%-79% of people have these symptoms
Arrhythmia
Abnormal heart rate
Heart rhythm disorders
Irregular heart beat
Irregular heartbeat

[ more ]

0011675
Chest pain
0100749
Respiratory insufficiency
Respiratory impairment
0002093
5%-29% of people have these symptoms
Abdominal pain
Pain in stomach
Stomach pain

[ more ]

0002027
Abnormal pleura morphology
0002103
Anorexia
0002039
Arthralgia
Joint pain
0002829
Ataxia
0001251
Bone marrow hypocellularity
Bone marrow failure
0005528
Cellulitis
Bacterial infection of skin
Skin infection

[ more ]

0100658
Diarrhea
Watery stool
0002014
Encephalitis
Brain inflammation
0002383
Endocarditis
0100584
Hallucinations
Hallucination
Sensory hallucination

[ more ]

0000738
Hematuria
Blood in urine
0000790
Hemoptysis
Coughing up blood
0002105
Hepatitis
Liver inflammation
0012115
Hyponatremia
Low blood sodium levels
0002902
Hypotension
Low blood pressure
0002615
Jaundice
Yellow skin
Yellowing of the skin

[ more ]

0000952
Lymphadenopathy
Swollen lymph nodes
0002716
Lymphopenia
Decreased blood lymphocyte number
Low lymphocyte number

[ more ]

0001888
Migraine
Intermittent migraine headaches
Migraine headache
Migraine headaches

[ more ]

0002076
Muscle weakness
Muscular weakness
0001324
Myocarditis
Inflammation of heart muscle
0012819
Nausea and vomiting
0002017
Pancreatitis
Pancreatic inflammation
0001733
Pericarditis
Swelling or irritation of membrane around heart
0001701
Peripheral neuropathy
0009830
Proteinuria
High urine protein levels
Protein in urine

[ more ]

0000093
Recurrent pharyngitis
Recurrent sore throat
0100776
Reduced consciousness/confusion
Disturbances of consciousness
Lowered consciousness

[ more ]

0004372
Renal insufficiency
Renal failure
Renal failure in adulthood

[ more ]

0000083
Restrictive ventilatory defect
Stiff lung or chest wall causing decreased lung volume
0002091
Sepsis
Infection in blood stream
0100806
Splenomegaly
Increased spleen size
0001744

Diagnosis

Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional.

Testing Resources

  • The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional.

Learn more

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • You can obtain information on this topic from the Centers for Disease Control and Prevention (CDC). The CDC is recognized as the lead federal agency for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the United States.
  • The Mayo Clinic Web site provides further information on Legionnaires’ disease.
  • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
  • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • MeSH® (Medical Subject Headings) is a terminology tool used by the National Library of Medicine. Click on the link to view information on this topic.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • The Occupational Safety & Health Administration (OSHA) of the United States Department of Labor has a comprehensive online page on Legionnaires’ disease that covers topics such as general information, symptoms, incidence rates and risk factors, diagnosis, and treatment.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Legionnaires’ disease. Click on the link to view a sample search on this topic.

References

  1. Legionnaires' disease. Mayo Clinic. January 11, 2018; https://www.mayoclinic.org/diseases-conditions/legionnaires-disease/symptoms-causes/syc-20351747.
  2. Cunha BA. Legionnaires Disease. Medscape Reference. June 9, 2017; https://emedicine.medscape.com/article/220163-overview.
  3. Legionella (Legionnaires’ disease and Pontiac Fever). Centers for Disease Control and Prevention (CDC). 2016; https://www.cdc.gov/legionella/index.html.
  4. Legionella (Legionnaires’ Disease and Pontiac Fever): Signs and Symptoms. Centers for Disease Control and Prevention (CDC). April 30, 2018; https://www.cdc.gov/legionella/about/signs-symptoms.html.
  5. Legionella (Legionnaires' Disease and Pontiac Fever): Causes, How it Spreads, and People at Increased Risk. Centers for Disease Control and Prevention (CDC). April 30, 2018; https://www.cdc.gov/legionella/about/causes-transmission.html.
  6. Legionnaires' Disease. MedlinePlus. March 25, 2016; https://medlineplus.gov/legionnairesdisease.html.
  7. Legionnaires’ Disease. National Organization for Rare Disorders (NORD). 2009; https://rarediseases.org/rare-diseases/legionnaires-disease/.
  8. Legionella (Legionnaires' Disease and Pontiac Fever): Diagnosis, Treatment, and Complications. Centers for Disease Control and Prevention (CDC). April 30, 2018; https://www.cdc.gov/legionella/about/diagnosis.html.