Legionellosis laboratory findings: Difference between revisions
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Revision as of 18:05, 23 November 2012
Legionellosis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory Findings
- Complete blood count and differential count - lymphocytopenia and rarely pancytopenia
- Sputum Gram staining - gram negative rods
- Urine antigen test - the urine antigen test is simple, quick, and very reliable; however it will only detect Legionella pneumophila serogroup #1. If the patient has pneumonia and the test is positive then the patient is considered to have Legionnaires’ disease. Also the urine antigen test will not identify the specific subtyping so it cannot be used to match the patient with the environmental source of infection. This test is 70% sensitive and 100% specific.
- Cultures - 80% sensitive and 100% specific.
- Antibody test (paired sera) - compare antibody levels to Legionella in two blood samples obtained 3 to 6 weeks apart. A 4 fold rise in titer between acute- and convalescent-phase specimens confirms the diagnosis. Has a sensitivity of 70% - 80% and specificity of >90%.
- Serum electrolytes - hyponatremia
- Liver function tests - elevated bilirubin levels
- Urinalysis - proteinuria
- Direct fluorescent antibody stain - 25-75% sensitive and 95% specific.
References