Legionnaires' Disease

What is Legionnaires' disease?

Legionnaires' disease is an infection of the lungs caused by bacteria called legionella. It causes a type of pneumonia.

What is the cause?

Legionella bacteria live in soil and water. The bacteria grow easily in warm, stagnant water, such as the water in some plumbing systems, hot water tanks, whirlpool baths or spas, and cooling towers of large air-conditioning systems. There is no evidence that bacteria are spread from air conditioners in cars or from household window air-conditioning units.

Legionnaires' disease occurs most often in summer and fall. During these seasons, people are more exposed to air conditioners and hot tubs, which may be contaminated with the bacteria.

The disease does not appear to spread from person to person.

You have a higher risk of having Legionnaire's disease if:

  • You are over 65 years old.
  • You smoke.
  • You have a chronic lung disease.
  • Your immune system doesn't work normally, for example, because of cancer or cancer therapy, diabetes, kidney failure, AIDS, or use of steroid drugs in high doses.

What are the symptoms?

The first symptoms of this disease are:

  • Fever and chills
  • Headache
  • General ill feeling
  • Muscle aches

Symptoms that occur 1 to 2 days later may include:

  • Cough, which can be dry, or it may bring up mucus or blood
  • Chest pain
  • Confusion
  • Diarrhea
  • Abdominal pain

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

  • Chest X-ray
  • Urine test
  • Blood tests
  • Sputum culture, which is a test of a sample of mucus coughed up from deep in your lungs

How is it treated?

If your healthcare provider thinks you may have Legionnaires' disease, your treatment will start right away, before all test results are back. If you are very sick, you will stay in the hospital, where you will be given IV antibiotics. If you are not severely ill, you may be able to take oral antibiotics and not have to stay in the hospital.

Treatment may include IV fluids to replace body fluids lost because of high fever, rapid breathing, and sweating. You may also need oxygen to help your breathing during the first few days.

How can I take care of myself?

  • Follow the treatment your healthcare provider prescribes.
  • If you have a fever above 100°F (37.8°C), stay in bed. When your temperature falls below 100°F (37.8°C), you may become as active as you comfortably can.
  • Drink more liquids (water or tea) every day to help you cough up mucus more easily unless your provider says you need to limit fluids because of another medical condition you have.
  • Cough up lung secretions as much as possible. Use cough medicine only if your provider recommends it.
  • Use a humidifier to put more moisture in the air. Avoid steam vaporizers because they can cause burns. Be sure to keep the humidifier clean, as recommended in the manufacturer's instructions. It's important to keep bacteria and mold from growing in the water container.
  • Ask your provider about taking aspirin, ibuprofen, or acetaminophen for fever or chest pain.
    • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.
    • Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome.
  • Use a heating pad on a low setting to reduce chest pain. Be careful not to fall asleep while you are using the heating pad.
  • Ask your provider:
    • How and when you will hear your test results
    • How long it will take to recover from this illness
    • What activities you should avoid and when you can return to your normal activities
    • How to take care of yourself at home
    • What symptoms or problems you should watch for and what to do if you have them
  • Make sure you know when you should come back for a checkup.

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