LEGIONELLOSIS WITH ACUTE RESPIRATORY-FAIL URE - CLINICAL AND BIOLOGICAL COMPARISONS WITH PNEUMOCCOCAL PNEUMONIA

Objectives: Legionnaires' disease is one of the main etiologies of bac terial pneumonias because of its frequency as well as its potential se verity, The therapeutic choice implies the need to look for distinctiv e clinical, biological or radiological signs, due to the unreliability of rapid immunological criteria, Pneumococcus is the first cause of b acterial pneumopathy, Thus, identifying the distinctive signs between these two etiologies may be necessary, Methods: In our restrospective study, nine Legionnaires' disease-related pneumonias were compared wit h nine pneumococcus-related pneumonias with acute respiratory failure and comparable level of severity, Patients were recruited over a two y ear period in a medical intensive care unit, Results: Four criteria we re found more frequently in pneumonia related to Legionnaires' disease : high-grade fever at the time of admission, elevated transaminases, p resence of Miller's criteria (converging clinical and biological signs ) and increasing creatine kinase, Conclusion: In patients with severe pneumonia, both Pneumococcus and Legionella should be entertained as p ossible diagnoses before starting treatment, A prospective analysis of precise diagnostic criteria is needed to distinguish between these tw o bacterial diseases.